Risk Factor Analysis of Intraoperative Femoral Metaphyseal Fractures in Cementless Hip Hemiarthroplasty

To investigate the risk factors for intraoperative femoral metaphyseal fractures during primary hip hemiarthroplasty (HHA). A retrospective analysis was conducted on patients who underwent primary HHA at our hospital from February 2013 to February 2023. Patients who sustained intraoperative femoral metaphyseal fractures were included in the study group, while those without fractures were included in the control group. Patient data, including age, sex, body mass index (BMI), surgical indication, Dorr classification of the femoral canal, Singh index, and pre- and postoperative Harris scores, were analyzed to identify risk factors for intraoperative fractures. A total of 2,795 cases were followed up, of which 103 experienced intraoperative femoral metaphyseal fractures, with an incidence rate of 3.6%. The Dorr classification of the femoral canal and the Singh index were identified as risk factors for intraoperative fractures during HHA. Further multivariate logistic regression analysis showed That the Dorr classification was an independent risk factor for intraoperative femoral fractures. For patients with preoperative risk factors undergoing primary HHA, careful preoperative planning and adequate intraoperative exposure are essential to minimize the occurrence of femoral metaphyseal fractures.