[Intra-operative fractures in hip arthroplasties: predisposing factors]

In a multi center study 51 cases of intraoperative femoral fractures in THA from 6 medical centers of eastern France were analysed with respect to epidemiology and predisposing factors. The male/female rate was 0,5 and the average age 73 years.The fractures involve the diaphysis in 33% and a cortical defect in 33%. The fracture occured in 50% of cases during reaming, or impaction of the femoral stem, and in 25% of cases during dislocation, these findings correspond to those described in the literature.The predisposing factors are of two types :- The rarefaction of the bone mineralisation due to the age and high proportion of females. 33% of the cases are a fracture of the femoral neck (elderly women).- Reoperation (27 cases) with 22 replacement of THA. In these cases of loosening, the fragility of the cortical bone (cement granuloma, chamber of mobility) is well known. On the other hand, we did not find that calcification or ankylosis are predisposing factors (only 8/51).