Seventy cases of fractures of the femur, occurring in fifty-nine patients with Paget's disease of bone, have been reviewed.
Twenty-six cases occurred in the subtrochanteric region. Only five were in the neck of the femur.
Union occurred within three months in thirteen cases and forty-nine cases united within six months. Union of these fractures appeared to take place at least as rapidly as in normal bone.
Fixation of the fragments with an intramedullary nail, after the medullary cavity had been reamed, was the most satisfactory form of treatment for fractures of the shaft of the femur. When the shaft is too bowed to allow this type of fixation open reduction and immobilization with plate and screws can be used.
In no patient in this series did a fracture cause sarcoma. Reference is made, however, to patients in whom malignant. change in the femur led to a spontaneous fracture.