{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:42:12Z","timestamp":1777880532467,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2008,4,1]],"date-time":"2008-04-01T00:00:00Z","timestamp":1207008000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2008,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose.<\/jats:title>\n                    <jats:p>To study the possible causes of intra-operative metaphyseal fractures in elderly patients undergoing hemiarthroplasty for displaced intracapsular femoral neck fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>36 men and 228 women aged 61 to 89 years with 273 displaced femoral neck fractures underwent hemiarthroplasty using a hydroxyapatite ceramic\u2013coated Furlong bipolar prosthesis. Anteroposterior and lateral radiographs were taken immediately after surgery to evaluate the presence and type of any intra-operative fractures (classified according to the Vancouver system) and their effect on stem stability or osseointegration. Pain and clinical outcomes were evaluated using a visual analogue scale and the Harris Hip Score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>Regarding the 273 surgeries for displaced femoral neck fracture, 28 (10%) were associated with intra-operative metaphyseal fracture (21 Vancouver type AL and 7 type AG). There was a correlation between intra-operative metaphyseal fractures and stem size. A size-9 stem was used in 64 surgeries without any fracture. A size-10 stem was used in 129 surgeries in which 11 (9%) sustained fractures, and a size-12 stem was used in 80 surgeries in which 17 (21%) sustained fractures. Postoperatively, 25 cases developed hip-related problems (thigh pain=14 and periprosthetic fractures=8) after 3 to 18 months. No patient whose metaphyseal fracture was fixed had hip problems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion.<\/jats:title>\n                    <jats:p>In elderly women with compromised bone quality, extra care is needed to achieve better fitting so as to avoid iatrogenic metaphyseal fractures. Under-sizing or cementing of the prosthesis is recommended when encountering difficulties.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/230949900801600108","type":"journal-article","created":{"date-parts":[[2016,10,4]],"date-time":"2016-10-04T17:13:55Z","timestamp":1475601235000},"page":"30-34","source":"Crossref","is-referenced-by-count":14,"title":["Association of Intra-Operative Metaphyseal Fractures with Prosthesis Size during Hemiarthroplasty of the Hip"],"prefix":"10.1177","volume":"16","author":[{"given":"KJ","family":"Barlas","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Diana Princess of Wales Hospital, Grimsby, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"QS","family":"Ajmi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Diana Princess of Wales Hospital, Grimsby, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"TK","family":"Bagga","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Diana Princess of Wales Hospital, Grimsby, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"FR","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Diana Princess of Wales Hospital, Grimsby, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JA","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Diana Princess of Wales Hospital, Grimsby, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Eltayeb","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Diana Princess of Wales Hospital, Grimsby, United 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