Treatment of manifest and impending pathologic fractures of the femoral neck by cemented hemiarthroplasty. Thirty-four patients with manifest or impending pathologic fractures of the femoral neck were treated between 1971 and 1987. Breast carcinoma was the primary tumor in the majority of patients. All patients were treated with cemented hemiarthroplasty. Twenty-seven patients (79%) could walk at an average of nine days postoperatively. All patients experienced relief of pain. Two superficial wound dehiscences, one loosening of the prosthesis, and two prosthetic dislocations were encountered. Mean survival was 17.6 months overall (12 months for manifest fractures and 40 months for impending fractures). These results indicate that cemented hemiarthroplasty for pathologic fractures is a safe procedure resulting in long-lasting palliation without necessitating postoperative irradiation. The importance of tumor excochleation and the advantages of bone cement are emphasized. 