Intraoperative fractures of the femur in prosthetic hip reimplantations.

A total of 19 cases of intraoperative fractures of the femoral diaphysis occurring during prosthetic hip reimplantation are described. Incidence, predisposing factors, treatment, and influence on long-term results are discussed. The pre-existence of osteolysis or narrowing of the femoral cortex, often associated with primary cemented implantation with a metal-polyethylene combination, constitutes a factor that predisposes the patient to fracture. Fracture consolidation occurs in most cases with minimum treatment, at times without instrumentation; fracture, however, always means a delay in weight-bearing and a slowing down in recovery times. Long-term clinical evaluation shows functional results that are worse for reimplantations complicated by fracture as compared to those where there are no complications. The differences in the radiographic results instead do not reveal statistical significance.