Treatment of Intertrochanteric Fractures in the Elderly with Minimally Invasive DAA for Hip Arthroplasty

Abstract Objectives: Direct Anterior Approach (DAA) is a nervous muscle space approach, which theoretically does not damage muscles and nerves, with less intraoperative bleeding, quick postoperative recovery and low dislocation rates and without contraindicated positions. It is considered as a truly minimally invasive approach for hip arthroplasty. Methods: 134 elderly patients with intertrochanteric fractures hospitalized from February 2019 to August 2023 were chosen for hip arthroplasty using DAA, including 70 women and 64 men aged 70-94, with an average age of 79.40 ± 4.80. Results: The incision length for hip replacement surgery was 10.14 ± 2.34 cm in length, the duration of surgery was 74.72 ± 12.54 min, intraoperative blood loss was 125.27±17.29 ml, the volume of postoperative drainage fluid was 122.43± 163.45 ml, the time of postoperative ambulation was 1.41±0.65 d, and the Harris hip score at six months after surgery was 93.57±4.85 points. There were three patients who experienced local numbness in the lateral thigh and no patients that suffered dislocations. Conclusion: Hip replacement for elderly patients with intertrochanteric fractures using DAA causes less damage to soft tissues with low complications, and contributes to early-stage functional exercise. It is a reliable minimally invasive therapy.