A Comparative Study of Posterior Approach versus Lateral Approach in Surgical Management of Intra-capsular Neck Femur Fractures

Abstract

Aims and Objective: The present study was undertaken to evaluate and compared relevant early surgical complications rates after posterior and lateral approach. Methods: A total 80 patients of either sex, age between 50-80 years with intracapsular neck femur fracture were operated with hemiarthroplasty. Patients were divided in two equal groups i.e. group A and B operated with posterior and lateral approach respectively. Several variables including age, sex, operative time, blood loss, early surgical and post-operative complications, post-operative care, hip function and final outcome measures were noted and compared between two groups. Results: The mean age of patients was 64.30 5.39 years in group A and 65.85 5.64 years in group B with female to male ratio was 1.6:1 for group A and 1.4:1 for group B. Operating time for group A and for group B was 48.435.38 and 47.507.59 minutes respectively. Mean intraoperative blood loss was 144.7517.68 ml in group A and 148.3815.03 ml in group B. The most common complication in both the groups was infection and rate in group A was 17.50% and in group B was 12.50%. Posterior approach carries an increased risk of prosthetic dislocation as compared to lateral approach. There was no intraoperative mortality seen in follow up period. The rate of secondary procedures was high with posterior approach (12.5%) as compared to lateral approach (7.5%). The average Harris Hip Score was 85.62% in group A and 83.40% in group B. Conclusion: The rate of early surgical complications and outcome measures after posterior and lateral approaches is not significantly different. A larger randomized trial or may be a multicentre trial can further improve the interpretation of the results.