A comparison of the minimally invasive and traditional lateral approaches for hemiarthroplasty following a femoral neck fracture: Reduced postoperative pain and fewer blood transfusions; Femoral boyun kırığı sonrası hemiartroplasti için minimal invaziv ve geleneksel lateral yaklaşımların karşılaştırılması, ameliyat sonrası ağrının azaldığını ve daha az kan transfüzyonu gerektiğini göstermektedir

Abstract

BACKGROUND: This study aimed to investigate the effects of the minimally invasive direct lateral approach, performed using standard hip surgery instruments, on operation duration, early postoperative pain, postoperative blood loss, and hospital stay in the treatment of femoral neck fractures with hemiarthroplasty (HA), compared with the standard Hardinge direct lateral approach (referred to in this study as the conventional group, CG). METHODS: We retrospectively collected clinical data from the medical records of our hospital. Inclusion criteria were a diagnosis of femoral neck fracture resulting from low-energy trauma and treatment with HA surgery. Patients were divided into two groups based on the surgical approach: the conventional group (CG) and the mini-incision group (MG). Twenty-four patients comprised the MG (case group), while 18 patients were in the CG (control group). The average wait time for surgery was 3.8 days for the MG and 3.6 days for the CG. Statistical analyses were conducted to evaluate differences in postoperative pain scores, hospital stay, postoperative blood transfusion, operation duration, hemoglobin, and hematocrit levels between the groups. RESULTS: There was no significant difference in age or gender distribution between the case and control groups (p>0.05). The average age of the mini-incision group was 83.8 years, while the average age of the CG was 86.9 years. In both groups, the fracture types were equally distributed between Garden type III and IV. However, the visual analog scale (VAS) scores on the first and third postoperative days were significantly lower in the case group than in the CG (p<0.05). Patients in the MG required significantly fewer postoperative blood transfusions compared to the control group. Hospitalization duration, as well as hemoglobin and hematocrit levels both preoperatively and at discharge, were comparable between the groups. CONCLUSION: The data from this study indicate that the mini-incision technique is an effective and reliable method for treating femoral neck fractures. Compared with the conventional group, the minimally invasive direct lateral approach for femoral neck fractures significantly reduces early postoperative pain, results in less blood loss, offers better cosmetic outcomes, and maintains a similar length of hospital stay. Clinical studies with larger sample sizes and assessments of long-term postoperative outcomes are necessary. © 2025, Turkish Association of Trauma and Emergency Surgery. All rights reserved.