Eleven intraoperative femur fractures occurred during 605 total hip replacements at Rancho Los Amigos Hospital, an incidence of 1.8%. Fractures occur more often in women, are usually located in the proximal femur, and mostly occur during femoral reaming. The main predisposing factors were osteoporosis and previous hip operation. The treatment may be operative or non-operative depending on the location and type of fracture. This complication is associated with a high morbidity and a significant delay in convalescence.