Lateral and Posterior Approaches in Hemiarthroplasty.

Area of Science:

• Orthopedic surgery
• Geriatric trauma care

Background:

• Hemiarthroplasty is a standard procedure for displaced femoral neck fractures in elderly patients.
• Choosing the optimal surgical approach is critical for patient recovery and functional outcomes.

Purpose of the Study:

• To compare lateral versus posterior surgical approaches for hip hemiarthroplasty in fragility femoral neck fractures.
• To evaluate differences in mobility, pain, dislocation, and survival at 12 months post-surgery.

Main Methods:

• A cohort of 393 patients (≥65 years) with fragility femoral neck fractures undergoing hemiarthroplasty was observed for 12 months.
• Data collected included pre-fracture status, in-hospital course, and 1-year follow-up via telephone.
• Final analysis included 269 patients.

Main Results:

• At 1 year, 22% of posterior approach patients were independent of mobility aids versus 12% with the lateral approach (p=0.026).
• The lateral approach was an independent predictor for needing mobility aids (OR=2.73).
• The posterior approach led to four dislocations (3.4%), while the lateral approach had none. Survival and pain were similar between groups.

Conclusions:

• The lateral approach for hip hemiarthroplasty is associated with a higher likelihood of requiring mobility aids one year post-fracture.
• The posterior approach increases the risk of hip dislocation.
• Careful patient selection is essential to determine the most suitable surgical approach for hip hemiarthroplasty.