Comparison of the Piriformis-Sparing and Posterolateral Approaches in Cementless Hemiarthroplasty for Femoral Neck Fractures
Hip and Pelvis, cilt.37, sa.4, ss.314-320, 2025 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 37 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.5371/hp.2025.37.4.314
- Dergi Adı: Hip and Pelvis
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.314-320
- Anahtar Kelimeler: Femoral neck fractures, Hip dislocation, Hip joint, Hip prosthesis, Piriformis muscle
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: With a focus on dislocation rates, this study aims to compare the posterior or posterolateral approach (PLA) with the piriformis-sparing approach (PSA) in elderly patients undergoing cementless hemiarthroplasty for displaced femoral neck fractures. Materials and Methods: This retrospective study included 194 patients who met the eligibility criteria and underwent surgery using the PLA (n=140) or the PSA (n=54). Patient data were reviewed for age, sex, body mass index, postoperative dislocation rate, presence of neurological conditions or other comorbidities, surgical duration, length of hospital stay, follow-up period, infection rate, admission to the intensive care unit (ICU), and mortality rate. Results: In Group 1 (PLA), 12 out of 140 patients (8.6%) experienced dislocation within a postoperative period of 1 to 5 years. Dislocations occurred in three out of 54 patients (5.6%) in Group 2 (PSA). Although the difference was not statistically significant (P=0.565), a significant difference was observed between the groups in terms of mortality (P=0.015) and surgical duration (P=0.0001). Conclusion: In terms of functional outcomes and postoperative pain management, the advantages of modified PLA have been highlighted in recent studies. Although no statistically significant difference was found in this study, a 3% lower dislocation rate was demonstrated by the PSA as compared to the PLA.