Clinical experience of direct anterior approach total hip arthroplasty in lateral position for treatment of elderly femoral neck fractures
Objective To summarize the clinical experience of total hip arthroplasty in the treatment of elderly femoral neck fractures through direct anterior approach in the lateral position,and analyze the learning curve of beginners.Methods A ret-rospective analysis was conducted on 30 elderly patients with femoral neck fractures treated with direct anterior total hip arthro-plasty from April 2020 to April 2022.The standard lateral position was taken,and the surgical position was the same as that of the posterior lateral approach.A skin incision was made from the anterior superior iliac spine to the base of the greater trochan-ter of the femur,with a length of about 8 cm or 4 transverse fingers.The incision direction was located on the line connecting the anterior superior iliac spine and the fibular head in the hip and knee extension positions.At the last follow-up,the Harris hip joint function score was used to evaluate the therapeutic effect.Results The surgical time in this group ranged from 40 to 210 minutes,with an average of 75 minutes The intraoperative bleeding volume ranged from 150 to 360 mL,with an average of 220 mL.All 30 cases were followed up for a period of 14 to 38 months,with an average of 25 months.20 cases were able to wear socks independently in the early postoperative period.During the follow-up period,all patients did not experience loosening of the prosthesis or dislocation of the hip joint.At the last follow-up,Harris score for hip joint function was excellent in 25 cases,good in 4 cases,and fair in 1 case.Conclusion The lateral position direct anterior approach total hip arthroplasty enters from the muscle space and nerve interface,which is in line with the minimally invasive concept and allows patients to recover quickly and early.Lateral position surgery can use conventional tools and prostheses,which is beneficial for surgeons to operate and grassroots hospitals to carry out,with a shorter learning curve.
Femoral neck fractureTotal hip arthroplastyLateral decubitus positionDirect anterior approachMinimally inva-siveOld age
NETL
NSTL
万方数据
