直接外侧入路与后外侧入路行人工股骨头置换术治疗老年股骨颈骨折的效果比较OA

Objective To compare the clinical outcomes of direct lateral approach and posterolateral approach in artificial femoral head replacement for elderly patients with femoral neck fractures.Methods A retrospective cohort study was conducted.Fifty elderly patients who underwent artificial femoral head replacement were divided into a direct lateral approach group(30 cases)and a posterolateral approach group(20 cases)based on surgical approaches.Perioperative indicators,Harris hip scores at different postoperative time points,and complication rates were compared between the two groups.Results Compared with the pos-terolateral approach,the direct lateral approach showed advantages in incision length,operative time,dom-inant blood loss,time to postoperative weight-bearing,and hospital stay(P<0.05).However,there was no significant difference in hidden blood loss between the two groups(P=0.409).All patients were followed up for 6～9 months,with an average of(7.2±1.4)months.The Harris hip scores at 1,3,and 6 months postoperatively were higher in the direct lateral approach group,and the differences at 1 and 3 months were statistically significant(P<0.05),while no difference was observed at 6 months(P>0.05).Postoperative complications occurred in2 patients(6.67%)in the direct lateral approach group and 5 patients(25%)in the posterolateral approach group,with no statistically significant difference between groups(P>0.05).Conclusions Both the direct lateral and posterolateral approaches achieve satisfactory clinical outcomes in arti-ficial femoral head replacement.However,the direct lateral approach is associated with shorter operation time,less surgical trauma,earlier mobilization,and faster recovery of hip function,which facilitates early rehabilita-tion in elderly patients and is worthy of clinical promotion.