[Objective]To evaluate the clinical efficacy of supercapsular approach(SC)for hemiarthroplasty(HA)in the treatment of unstable femoral intertrochanteric fractures in the elderly.[Methods]A retrospective study was conducted on 50 patients who received hemiarthroplasty for unstable femoral intertrochanteric fractures in our department from April 2017 to March 2020.Based on doctor-pa-tient communication,25 patients had HA performed though the SC approach,while other 25 patients were through the posterolateral ap-proach(PL).The perioperative,follow-up and imaging data of the two groups were compared.[Results]The SC group was significantly su-perior to the PL group in terms of operation time[(60.5±8.5)min vs(74.0±6.5)min,P＜0.05],incision length[(8.2±0.5)cm vs(12.1±1.1)cm,P＜0.05],intraoperative blood loss[(200.8±29.7)ml vs(297.2±23.0)ml,P＜0.05],the ambulation time[(1.8±0.7)days vs(3.2±0.8)days,P＜0.05]and hospital stay[(9.6±1.4)days vs(11.7±2.0)days,P＜0.05].All patients were followed up for more than 12 months,and the SC group returned to full weight-bearing activity significantly earlier than the PL group[(5.6±1.0)weeks vs(6.8±1.2)weeks,P＜0.05].The Har-ris score,hip extension-flexion ROM,and internal-external rotation ROM significantly increasedin both groups at the last follow-up com-pared with those preoperatively(P＜0.05).By the time of the last follow-up,the SC group was significantly better than the PL group in terms of Harris score[(79.4±2.6)vs(73.9±3.3),P＜0.05],hip extension-flexion ROM[(97.0±5.0)° vs(93.2±4.3)°,P＜0.05],internal-external rota-tion ROM[(57.6±5.9)° vs(52.2±5.7)°,P＜0.05].Regarding image,the leg length discrepancy(LLD)decreased significantly over time in both groups(P＜0.05).However,there were no significant differences in LLD,quality of fracture reduction and prosthetic position between the two groups at any time points accordingly(P＞0.05),no hip dislocation or prosthesis loosening occurred in anyone of both groups.[Conclu-sion]The SC approach used in HA has the advantages of minimally invasive surgery,shorter operation time,less intraoperative bleeding,less postoperative pain and faster recovery over the PL approach for the treatment of unstable femoral intertrochanteric fracture in the elderly.
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