Many of the devices used in the internal fixation of femoral neck frac
tures are cannulated and require the initial placement of one or more
guidewires for accurate positioning. These wires are occasionally adva
nced inadvertently through the hip joint and the acetabulum. Pelvic vi
sceral damage may follow. To assess this risk, we inserted three guide
wires to a depth of 16 cm into each femoral neck of ten cadavers and e
xplored the pelvis during autopsy. Thirty-two of the 60 guidewires had
penetrated a pelvic organ. The literature on intrapelvic injuries ass
ociated with hip surgery is reviewed, and suggestions are offered on t
he avoidance of pelvic penetration during hip fracture fixation.