الفهرس 
Direct anterior approach versus direct lateral approach in arthroplasty for femoral neck fractures
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Abstract
Background: Femoral neck fractures (FNFs) in the elderly require special consideration to use methods that is less prone to dislocation and facilitate early recovery of walking ability and activities of daily living (ADLs). Controversy exists as to whether early functional outcomes differ after total hip arthroplasty (THA) performed using different common approaches. Direct anterior approach (DAA) has been reported to be beneficial in THA for hip osteoarthritis as it facilitates early recovery of walking ability with lower dislocation rate. Direct lateral approach (DLA) allows for excellent exposure but may lead to Trendelenburg gait, trochanteric bursitis and a greater risk of dislocation. Objectives: The aim of this study was to compare total hip arthroplasty for FNFs via Direct Anterior Approach versus Direct Lateral Approach regarding short term clinical and functional outcomes and evaluation of complications. Patients & Methods: This study was Prospective Randomized Controlled trial (PRCT) including 50 patients. Patients were randomized using sealed opaque envelopes into two groups based on surgical approach 25 patients in each group. group A included patients who had a THA using a DAA, while group B included who had a THA using a DLA. Patients were followed up for 6 months; perioperative and postoperative short term clinical, radiological and functional outcome using Harris Hip Score (HHS) were documented. Results: Demographic data were comparable for the DAA and DLA.Comparison of the peri-operative outcomes indicated that the DAA was associated with shorter incision length (10.56 vs 17.64 cm; p <0.01) and less intraoperative estimated blood loss (654 vs 792 ml, p <0.01). The DAA group reported significantly lower self-reported pain (2.44 vs 4.60 VAS score; p <0.01). However, DAA had shorter operative times (102.6 vs 118.6 min, p<0.01). We did not record any intra-operative femoral fracture or any LFCN neuropraxia in the DAA