Objective To compare the clinical effect between anterolateral approach and posterolateral approach for hemiarthroplasty in the treatment of elderly patients with displaced femoral neck fracture.

Methods A total of 96 elderly patients with femoral neck fracture were selected as research objects, and all of them were treated with hemiarthroplasty. According to the surgical approaches, there were 40 cases in the anterolateral approach group and 56 cases in the posterolateral approach group. The clinical efficacy was compared between the two groups.

Results The intraoperative blood loss, incision length, surgical time, postoperative bed-off activity time and postoperative hospital stay of patients in the anterolateral approach group were significantly better than those in the posterolateral approach group (P < 0.05); on the first and the second days after operation, the levels of C-reactive protein and serum creatine kinase in the anterolateral approach group were significantly lower than those in the posterolateral approach group (P < 0.05); at 12, 24 and 48 hours after surgery, the pain scores in the anterolateral approach group were significantly lower than those in the posterolateral approach group (P < 0.05); at hospital discharge and 4 weeks after surgery, the scores of Harris hip joint function in the anterolateral approach group were significantly higher than those in the posterolateral approach group (P < 0.05); the total incidence of postoperative complications in the anterolateral approach group was 5.0%, which was significantly lower than 19.6% in the posterolateral approach group (P < 0.05).

Conclusion Compared with the posterolateral approach, the anterolateral approach for hemiarthroplasty can cause less trauma in the treatment of elderly patients with displaced femoral neck fracture, with a better efficacy and faster postoperative recovery.