Hip Hemiarthroplasty for Femoral Neck Fracture

Replacement of the femoral head with a stem and a unipolar or bipolar head, leaving the socket alone. The rhythm is: approach, neck cut, remove and measure the head, prepare the canal, trial, then implant (cemented or press-fit) and repair.

Position and prep

Lateral decubitus with a hip positioner, injured side up; arms and pressure points padded; or supine for an anterior approach, per surgeon.

Prep: Hip, flank and leg to the ankle, leg free-draped.

Room setup

Hip positioner or pegboard
Power saw (tested, blade per surgeon)
Pulse lavage
Cement mixing setup if cemented
Hemiarthroplasty system trays, trials and implants

Implants

Femoral stem: cemented or press-fit, per surgeon
Modular head: unipolar or bipolar, sized to the removed head
Cement restrictor and cement if cemented

Instruments

Hip retractor set: self-retaining hip retractor, Hohmann retractors, bent Hohmanns
Cobb elevator
Femoral head extractor (corkscrew) and head measuring gauge
Box osteotome, canal finder, broaches or rasps in order
Trial necks and heads
Head impactor and mallet
Bone hook
Heavy needle drivers and closing tray

In the free instrument guide: Hohmann retractor, Cobb elevator, Osteotome vs. Chisel, Orthopedic mallet, Mayo-Hegar Needle Holder.

How the case runs

Time-out, including laterality and the implant plan (cemented or press-fit)
Approach per surgeon; capsulotomy
Neck cut with the saw at the planned level
Remove the head with the corkscrew; measure it; keep it on the back table for sizing and per specimen policy

The rest of the case is in the app

6 more steps, the Mayo setup, draping order, closing, pearls, and a three-stage “what would you do next?” case. Free to start.

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Clinically reviewed by William Guglielmo on October 15, 2026. Generic teaching content. Your surgeon's preference card, the implant system's technique guide and facility policy always come first.