2023, Vol. 27 ›› Issue (27): 4312-4317

Assistance of traction table for total hip arthroplasty through the direct anterior approach for treating femoral neck fracture in the elderly

Li Junran1, 2, Zhai Jingxiu2, Zhao Hongbo3, Wang Lei2, Wang Hongrun2, Liang Junsheng1, Li Ligeng1, 2   

Abstract: BACKGROUND: Total hip arthroplasty through the direct anterior approach has a significant minimally invasive effect and has the advantages of less soft tissue damage, less bleeding, less pain, and fast recovery. However, it is difficult to operate. Whether the traction table should be required or not during surgery is still controversial.  
OBJECTIVE: To analyze the clinical efficacy of assisting by the traction table in direct anterior approach-total hip arthroplasty for femoral neck fracture in the elderly.
METHODS: A retrospective study was conducted to assess the clinical data of 126 elderly patients with femoral neck fractures from January 2019 to March 2020 in Second Hospital of Tangshan. 67 patients were operated by the assistance of traction table and included as the traction table group. 59 patients were operated in non-traction table and set as the conventional operation group. The preoperative preparation time, the operation time, the anesthesia time, intraoperative blood loss, and postoperative radiological evaluation of prosthesis were recorded between the two groups. Hip joint function after operation was assessed by Harris score. Complications in the two groups were documented.  
RESULTS AND CONCLUSION: (1) All patients were followed up over 12 months after operation. (2) The traction table group showed significant longer preoperative preparation time, shorter operation time, less intraoperative blood loss and better central fixation ratio of femoral prosthesis than those in the conventional operation group (P < 0.05). (3) No significant difference was found between the traction table group and the conventional operation group for the anesthesia time, the ratio of the acetabular cup located in the safe zone, the ratio of limb length discrepancy shortened than 10 mm, Harris scores and complications in 1 week, 1, 6 and 12 months after the operation (P > 0.05). (4) The results conclude that compared with performing traditional total hip arthroplasty through the direct anterior approach without the use of a traction table on the treatment of geriatric patients suffering from femoral neck fracture, assistance of traction table in direct anterior approach-total hip arthroplasty can significantly shorten operation time, reduce the intraoperative blood loss and improve accuracy of femoral prosthesis. However, using a traction table can also prolong the preoperative preparation time.

Key words: traction table, direct anterior approach, femoral neck fracture, total hip arthroplasty, elderly, hip