Observation on the effect of modified hemiarthroplasty for the treatment of osteoporotic femoral neck fractures in elderly patients

WANG Yin; LI Yinpeng; LI Ximing; HAO Ming; CAO Bin; WU Tao

doi:10.3969/j.issn.1002-3429.2025.22.010

Abstract：Objective To investigate the clinical effect of modified hemiarthroplasty for the treatment of osteoporotic femoral neck fractures in elderly patients.Methods Sixty-eight elderly patients with osteoporotic femoral neck fractures from January 2019 to December 2022 were selected and divided into two groups by random number table method,with 34 patients in each group.The conventional group underwent conventional hemiarthroplasty,while the minimally invasive group underwent modified hemiarthroplasty via the SuperPath approach combined with a superolateral small incision.The surgery-related indicators,trauma indicators[erythrocyte sedimentation rate(ESR),serum C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],Harris hip score,activities of daily living[modified Barthel index(MBI)score],balance function[Berg balance scale(BBS)score]before and after surgery,and incidence of complications were compared between the two groupss.Results The duration of operation and incision length in the minimally invasive group were shorter than those in the conventional group,and the intraoperative blood loss and postoperative drainage volume were less than those in the conventional group;the postoperative ambulation time,fracture healing time,and length of hospitalization were shorter than those in the conventional group(P＜0.05).The levels of serum CRP,IL-6,TNF-α and ESR at 1 and 3 d after operation in the two groups were higher than those before operation,which,however,were lower in the minimally invasive group than in the conventional group(P＜0.05).The Harris hip score,BBS score and MBI score of the two groups at 6 and 12 months after operation were higher than those before operation,which were higher in the minimally invasive group than in the conventional group(P＜0.05).The excellent and good rate of hip function in the minimally invasive group was higher than that in the conventional group at 6 months and 12 months after operation(P＜0.05),and the total incidence of complications was lower in the minimally invasive group than in the conventional group(P＜0.05).Conclusion In the treatment of osteoporotic femoral neck fracture in the elderly,modified hemiarthroplasty via SuperPath approach combined with superolateral small incision can significantly optimize the operation,reduce the degree of trauma,accelerate the postoperative rehabilitation process,promote the recovery of hip function,and reduce complications.