{
  "abstract": "Background/Objective: Intraoperative femoral fractures during cementless hemiarthroplasty may present with distinct anatomical patterns. We examined whether surgical approach was associated with greater trochanteric versus stem-stable periprosthetic fracture patterns in older patients with osteoporotic-type femoral morphology; stem geometry was evaluated as an additional implant-related factor. Methods: We retrospectively reviewed 292 patients aged ≥75 years who underwent cementless bipolar hemiarthroplasty for low-energy displaced femoral neck fractures at a tertiary referral trauma center between January 2019 and July 2023. Patients were grouped according to stem geometry (fit-and-fill or tapered-wedge) and surgical approach (lateral or posterior). Associations were assessed using multivariable logistic regression, Firth-penalized regression, and stabilized inverse probability of treatment weighting (IPTW). Results: Intraoperative fractures occurred more frequently with the lateral approach than with the posterior approach (23.7% vs. 12.2%; p = 0.015), primarily because of greater trochanteric fractures (9.5% vs. 2.4%; p = 0.016). Periprosthetic fracture rates did not differ significantly between the approaches (14.2% vs. 9.8%; p = 0.284). In the Firth model, the posterior approach was associated with lower odds of greater trochanteric fracture (OR 0.25, 95% CI 0.08–0.80; p = 0.019); after IPTW, the corresponding estimate was OR 0.19 (95% CI 0.05–0.76; p = 0.019). Conclusions: The surgical approach was primarily associated with greater trochanteric fractures, whereas no independent association was observed with stem geometry. Pattern-specific analysis may provide a clearer characterization of intraoperative fracture associations in this setting.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopedics and Traumatology, Ankara Dışkapı Training and Research Hospital, Ankara 06110, Türkiye",
    "Department of Orthopedics and Traumatology, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara 06290, Türkiye",
    "Department of Orthopedics and Traumatology, Yuksek Ihtisas University, Ankara 06530, Türkiye",
    "Department of Orthopedics and Traumatology, Mardin Training and Research Hospital, Mardin 47100, Türkiye"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ali Tecirli",
      "orcid": "0000-0003-3535-4100"
    },
    {
      "affs": [
        1
      ],
      "name": "Seyyid Serif Unsal"
    },
    {
      "affs": [
        2
      ],
      "name": "Tugrul Yildirim"
    },
    {
      "affs": [
        3
      ],
      "name": "Alp Karacoban"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/33v8xr6039jz6.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15197666",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666352/?tool=EBI",
  "id": "33v8xr6039jz6",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13666352",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Hip and Femur Fractures"
    ]
  ],
  "openalex": "W7220404862",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666352/pdf/?tool=EBI",
  "pmcid": "PMC13666352",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/33v8xr6039jz6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:31Z",
      "native_id": "PMC:PMC13666352",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13666352"
    },
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15197666",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/19/7666"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Hip and Femur Fractures",
      "subfield": "surgery"
    }
  ],
  "title": "Association of Surgical Approach with Intraoperative Femoral Fracture Patterns During Cementless Hemiarthroplasty for Femoral Neck Fracture",
  "title_text": "Association of Surgical Approach with Intraoperative Femoral Fracture Patterns During Cementless Hemiarthroplasty for Femoral Neck Fracture",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:00Z",
  "url": "https://research.draconitic.com/paper/33v8xr6039jz6",
  "venue": "Journal of clinical medicine",
  "versions": []
}