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21 January 2020 : Clinical Research  

Direct Anterior Approach Versus Posterolateral Approach for Hemiarthroplasty in the Treatment of Displaced Femoral Neck Fractures in Geriatric Patients

Cagri Neyisci1ABCDEF, Yusuf Erdem1ABCDEF*, Ahmet Burak Bilekli1ABCDEF, Dogan Bek1ABCDEF

DOI: 10.12659/MSM.919993

Med Sci Monit 2020; 26:e919993

Abstract

BACKGROUND: In the present study, we aimed to evaluate early clinical and biochemical outcomes of direct anterior approach (DAA) versus posterolateral approach (PLA) for hemiarthroplasty in the treatment of displaced femoral neck fractures in geriatric patients.

MATERIAL AND METHODS: Between September 2012 and September 2017, a total of 110 patients who underwent hemiarthroplasty for displaced femoral neck fractures were retrospectively analyzed. The patients were divided into 2 groups according to the surgical technique PLA (Group 1, n=54) and DAA (Group 2, n=56). Clinical and biochemical results were compared.

RESULTS: There was no significant difference in the demographic characteristics of the patients, fixation type, and follow-up (P>0.05). However, there was a significant difference in the duration of surgery, amount of blood transfusion, change from baseline in postoperative hemoglobin levels, amount of intraoperative gauze dressing, amount of drainage fluid from the surgical wound, postoperative VAS scores, incision length, length of hospital stay, and Barthel Index scores in favor of DAA group (P<0.05). There was no significant difference in the degree of mobilization (P>0.05). None of the patients had postoperative complications in Group 1, while 3 patients in Group 2 developed a lateral femoral cutaneous nerve lesion and one patient had a missed iatrogenic fracture of the greater trochanter.

CONCLUSIONS: Our study results suggest that early clinical and biochemical outcomes are better in DAA than PLA with early return to daily living activities in patients undergoing hemiarthroplasty for displaced femoral neck fractures.

Keywords: Femoral Neck Fractures, Geriatrics, hemiarthroplasty, Surgical Procedures, Minimally Invasive, Aged, Aged, 80 and over, Arthroplasty, Replacement, Hip, Femur, Length of Stay, Male, Postoperative Complications, Retrospective Studies, Treatment Outcome

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750