Evaluation Of The Efficacy Of Anterolateral Approach For Artificial Femoral Head Replacement In Elderly Patients With Femoral Neck Fracture

Objective:Observation of the clinical effect of artificial femoral head replacement with anterior lateral small incision in elderly patients with femoral neck fracture.Methods:a retrospective analysis was performed on 60 patients with femoral neck fracture who were admitted to the orthopaedic department of yantai zhifu hospital from March 2016 to September 2019.30 patients underwent artificial femoral head replacement using the anterolateral minimally invasive approach(AMLI group)and 30 patients underwent artificial femoral head replacement using the traditional posterolateral approach(PLA group).Surgical wound length,operative time,blood loss,c-reactive protein(CRP),creatine kinase(CK),length of stay,and incidence of postoperative joint dislocation were compared between the two groups.After 1 month,3 months and 6 months,regular follow-up was conducted to evaluate the postoperative recovery of the two groups of patients by reviewing the orthotopic pelvic radiographs and the orthotopic lateral radiographs of the affected side femur,as well as the postoperative joint function(Harris)and VAS scores.SPSS 22.0 data analysis software was used for statistical analysis。The measurement data are expressed by mean ± standard deviation(x± SD),and the difference between the two groups is compared by t-test.Results:there was no significant statistical difference between the operation time of ALMI group and that of PLA group(p>0.05).Intraoperative bleeding in ALMI group was less than that in PLA group(p<0.05).The incision length of ALMI group was significantly smaller than that of PLA group(p<0.05).There was no significant difference in postoperative c-reactive protein between the ALMI group and the PLA group(p>0.05).The postoperative creatine kinase value of the ALMI group was lower than that of the PLA group,with significant statistical difference(p>0.05).There was no significant difference in postoperative hospital stay between the ALMI group and the PLA group(p>0.05).The incidence of postoperative joint dislocation in ALMI group was significantly different from that in PLA group(p<0.05).The Harris score of postoperative joint function in the ALMI group was better than that of the PLA group at 1 month and 3 months after the operation(p<0.05).There was no significant statistical difference between the two groups at 6 months(p>0.05).VAS score of ALMI group was significantly better than that of PLA group(p<0.05).Conclusion:the use of minimally invasive anterolateral approach for artificial femoral head replacement can achieve better clinical results,compared with the traditional anterolateral approach has the advantages of less surgical trauma and lower postoperative dislocation rate.It is helpful for the early recovery of elderly patients with femoral neck fracture.