Abstract
We assessed the relationship between the onset of pain and the fall in a consecutive series of 1, 212 patients admitted to a single hospital with an acute hip fracture. 915 patients could be evaluated. The overall incidence of spontaneous fractures was 7%, but this fell to 5% if pathological fractures were excluded. The incidence of fractures without a fall was 6%, 2% of patients gave a history of pain for up to 8 weeks before the fall and only 2 of the patients gave a history of acute pain in the hip, causing them to fall. Physicians should be aware that a spontaneous hip fracture can occur without any history of trauma and such fractures are likely to be pathological or intracapsular.