Comparison of early clinical effects between direct superior approach and posterolateral approach in hemiarthroplasty of femoral neck fracture in the elderly / 中国骨伤

OBJECTIVE@#To compare and analyze the early clinical effect of direct superior approach(DSA) and posterior lateral approach (PLA) in hemiarthroplasty for elderly patients with femoral neck fracture.@*METHODS@#The clinical data of 72 elderly patients with femoral neck fracture who underwent hemiarthroplasty from January 2020 to December 2021 were retrospectively analyzed. Among them, 36 patients were operated through minimally invasive DSA including 10 males and 26 females with an average age of (82.82±4.05) years old; the other 36 patients underwent traditional PLA including 14 males and 22 females with an average age of (82.79±3.21) years old. The perioperative related indexes and Harris scores during follow-up between two groups were compared.@*RESULTS@#Comparison of operation time between two groups, (79.41±17.39) min of DSA group was shorter than(98.45±26.58) min of PLA group;incision length (8.33±2.69) cm was shorter than (11.18±1.33) cm of PLA group;intraoperative blood loss (138.46±71.58) ml was less than (173.51±87.17) ml of PLA group, initial landing time (3.04±0.95) d was earlier than (4.52±1.10) d of PLA group, hospitalization time (8.70±1.89) d was shorter than (10.67±2.35) d of PLA group(P<0.05). There was no statistical difference in Harris score between two groups before operation(P>0.05), but Harris score in DSA group was higher than that of PLA group at 1 month after operation(P<0.05), but at 12 months after operation, the difference was not statistically significant between two groups(P>0.05).@*CONCLUSION@#Compared with PLA, DSA is superior in clinical indexes such as operation time, intraoperative blood loss, incision length, first landing time, length of hospitalization and Harris score in the first month after operation in hemi hip replacement, and has comparative advantages in promoting early postoperative rehabilitation of elderly patients with femoral neck.

Analysis on related factors of perioperative total blood loss in unilateral total hip arthroplasty / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the influential factors of total blood loss during unilateral artificial total hip arthroplasty (THA).</p><p><b>METHODS</b>From January 2014 to July 2016, 131 patients undergwent primary unilateral total hip arthroplasty, including 55 males and 76 females, ranging in age from 40 to 89 years old, with an average of 64.5 years old. The data of patients with unilateral total hip arthroplasty were collected, and the data of hemodynamics, coagulation function, hemoglobin and hematocrit values were recorded according to the observation data. The blood loss of the patients was calculated by Gross equation, and the data were analyzed by a statistical software.</p><p><b>RESULTS</b>The total blood loss of the patients was significantly affected by the factors of pathogenesis and deep venous thrombosis of the lower limbs. The results were statistically significant(<0.05). The gender, age, body mass index, prosthesis and anesthesia had little effects on the blood loss volume after replacement.</p><p><b>CONCLUSIONS</b>The data in this study indicate that the volume of actual blood loss can be controlled by adjusting non-surgical factors such as gender, age, body mass index, prosthetic material, and risk factors, and surgical factors(postoperative complications, anesthesia).</p>