Analysis of the functional outcome for lateral versus posterior approaches in hemiarthroplasty for femoral neck fractures

Context: Hip fractures are a common injury. Fracture neck of femur will become more common as the world's population ages and life expectancy increases. The frequency of the fracture also doubles every decade after the fifth decade of life. The lifetime risk of hip fractures is predicted to be 11.2% for women and 23.3% for males. (2). Numerous techniques can be used to execute hemiarthroplasty. The anterior approach, referred to as the Smith Petersen approach, the lateral Hardinge approach, the anterolateral Watson Jones approach, and the posterior approach, known as the southern-moore approach, are the most commonly employed techniques (5). The lateral and posterior approaches are the most frequently employed among them. Objectives: The purpose of this study is to evaluate the advantages and disadvantages of posterior versus lateral approaches for hemi replacement arthroplasty with respect to functional results and activities of daily living and to evaluate the complications connected to each approach and compare the complications associated to each approach. Methodology: Eighty individuals over sixty who had been diagnosed with a fracture to the femur neck were included in this study. Forty patients had hemi-replacement arthroplasty using a posterior approach, and another forty got direct lateral approach. We assessed these patients' functional outcomes using the Harris hip score (HHS), WOMAC score, and Merle d'Aubigne score. To assess muscle strength, the Trendelenburg sign was used with repeated leg abduction and leg press exercises. The radiography results were discovered. The complications were tabulated and compared. In SPSS, a chi-square chart was utilized to examine the data. Results: Both the posterior procedure and the lateral approach yielded good averaged Harris hip scores; the posterior approach's value was greater but not statistically significant. For both strategies, the WOMAC and Merle d'Aubigne scores produced good results. The posterior approach resulted in more complications than the lateral approach, including six cases of wound infections and six occurrences of hip dislocations. There were two occurrences of foot drop in the posterior approach. Post-operative limp was more pronounced in the lateral approach. Conclusion: Given that there was no statistically significant difference in the functional outcome between the posterior and lateral approaches, we may conclude that both approaches are feasible options for doing Hemi-replacement arthroplasty in patients with femur neck fracture. Even though the posterior approach had some additional risks, like the possibility of hip dislocations, foot drop, and wound infections, these were not significant enough to rule it out.