Correlation analysis of the influence of direct lateral approach and posterolateral approach on reoperation and dislocation in patients with femoral neck fracture

Abstract

To compare the relationship between direct lateral approach and posterolateral approach in the treatment of femoral neck fracture, and to provide reference for the choice of the best approach. From January 2015 to December 2018, 266 patients with femoral neck fracture underwent hip replacement were selected, including 154 males and 112 females, aged 58 to 74 (69.8±8.1) years. Direct lateral approach and posterolateral approach were used in 133 cases in each group. The difference of reoperation rate and dislocation rate between the two groups was compared. Cox proportional risk regression model was used to evaluate the potential factors of reoperation and dislocation after total hip replacement. The rate of reoperation and dislocation in direct lateral approach group was lower than that in posterolateral approach group (P<0.05) . Cox proportional risk regression model showed that posterolateral approach had higher postoperative reoperation rate and dislocation rate than direct lateral approach, and its relative risk ratio (95%CI) was, reoperation［2.65 (1.23- 5.36) , P=0.02］; dislocation［5.15 (1.68-9.15) , P=0.01］. Posterolateral approach is the influencing factor of reoperation and dislocation after hip replacement. Age, gender, cognitive dysfunction, replacement position, ASA score and other factors have no effect on reoperation and dislocation.