{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:29:18Z","timestamp":1787027358020,"version":"build-2736575974"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010847","name":"Science and Technology Project of Health and Family Planning Commission of Jiangxi Province","doi-asserted-by":"publisher","award":["202211373"],"award-info":[{"award-number":["202211373"]}],"id":[{"id":"10.13039\/501100010847","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>\n                    Hemiarthroplasty is a surgical choice for super-aged patients with a high surgical risk and a sedentary lifestyle. The direct superior approach (DSA), a minimally invasive modification of the posterior approach, is rarely studied in hemiarthroplasty. The aim of the present study was to compare the clinical outcomes in elderly patients with displaced femoral neck fractures undergoing hemiarthroplasty\n                    <jats:italic>via<\/jats:italic>\n                    DSA with the conventional posterolateral approach (PLA). A total of 48 elderly patients with displaced femoral neck fractures who underwent hemiarthroplasty between February 2020 and March 2021 were retrospectively included in the study. Of them, 24 patients (mean age 84.54\u2009\u00b1\u20092.11 years) were treated with hemiarthroplasty\n                    <jats:italic>via<\/jats:italic>\n                    DSA (DSA group), while the other 24 patients (mean age 84.92\u2009\u00b1\u20092.15 years) were treated with hemiarthroplasty\n                    <jats:italic>via<\/jats:italic>\n                    PLA (PLA group). Clinical outcomes, perioperative data, and complications were recorded. There were no obvious differences in the baseline characteristics between the DSA and PLA groups, including age, gender, body mass index, Garden type, American Society of Anesthesiologists score, and hematocrit. Perioperative data showed that the length of the incision in the DSA group was smaller than that in the PLA group (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&amp;lt;\u20090.001). However, the duration of the operation and blood loss in the DSA group were longer and higher than those in the PLA group, respectively (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&amp;lt;\u20090.001). In addition, the DSA group had a shorter hospitalization time than the PLA group (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&amp;lt;\u20090.001). The visual analog scale score and Harris score 1 month postoperatively in the DSA group were better than those in the PLA group (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&amp;lt;\u20090.001). Moreover, there were no significant differences between the two groups in Harris score (for assessment dysfunction) 6 months postoperatively (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&amp;gt;\u20090.05). DSA is less invasive and has better clinical outcomes, which can allow an early return to daily living activities in elderly patients with displaced femoral neck fractures undergoing hemiarthroplasty.\n                  <\/jats:p>","DOI":"10.3389\/fsurg.2023.1087338","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:45:30Z","timestamp":1678754730000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Outcomes of direct superior approach and posterolateral approach for hemiarthroplasty in the treatment of elderly patients with displaced femoral neck fractures: A comparative study"],"prefix":"10.3389","volume":"10","author":[{"given":"Wei","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Bo","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Hua","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin-Chu","family":"Shao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Chun","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"De-En","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Shuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"516","DOI":"10.5272\/jimab.2014204.516","article-title":"Epidemiology and social burden of the femoral neck fractures","volume":"20","author":"Filipov","year":"2014","journal-title":"J IMAB"},{"key":"B2","doi-asserted-by":"publisher","first-page":"C1","DOI":"10.1016\/S0020-1383(02)00324-8","article-title":"Epidemiology of femoral neck fractures","volume":"33","author":"Thorngren","year":"2002","journal-title":"Injury"},{"key":"B3","doi-asserted-by":"publisher","first-page":"22","DOI":"10.3390\/geriatrics5020022","article-title":"Surgical treatment of femoral neck fractures: a brief review","volume":"5","author":"Lutnick","year":"2020","journal-title":"Geriatrics"},{"key":"B4","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1186\/s13018-020-01958-2","article-title":"The choice of screw internal fixation and hemiarthroplasty in the treatment of femoral neck fractures in the elderly: a meta-analysis","volume":"15","author":"Cui","year":"2020","journal-title":"J Orthop Surg Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1097\/BOT.0000000000000291","article-title":"Femoral neck fractures: current management","volume":"29","author":"Florschutz","year":"2015","journal-title":"J Orthop Trauma"},{"key":"B6","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1007\/s40520-019-01394-1","article-title":"Predictors of early failure of the cannulated screw system in patients, 65 years and older, with non-displaced femoral neck fractures","volume":"32","author":"Biz","year":"2020","journal-title":"Aging Clin Exp Res"},{"key":"B7","doi-asserted-by":"publisher","first-page":"4010","DOI":"10.1007\/s11999-014-3957-3","article-title":"Revision surgery occurs frequently after percutaneous fixation of stable femoral neck fractures in elderly patients","volume":"472","author":"Kain","year":"2014","journal-title":"Clin Orthop Relat Res"},{"key":"B8","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1007\/s11999-013-3245-7","article-title":"Randomized trial of hemiarthroplasty versus internal fixation for femoral neck fractures: no differences at 6 years","volume":"472","author":"St\u00f8en","year":"2014","journal-title":"Clin Orthop Relat Res"},{"key":"B9","doi-asserted-by":"publisher","first-page":"2672","DOI":"10.1007\/s11999-015-4345-3","article-title":"Does arthroplasty provide better outcomes than internal fixation at mid- and long-term followup? 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