Abstract: Objective To compare the effect of using lateral decubitus DAA direct anterior approach and posterolateral hip approach during total hip replacement, and find a suitable surgical approach for patients with femoral neck fracture. Methods A total hip arthroplasty was used to divide 70 patients with femoral neck fracture admitted to our hospital from June 2022 to June 2023 as the research subjects, and the patients were divided into two groups by random number table method (named by observation group and control group, respectively).All patients underwent total hip replacement. Results The intraoperative blood loss volume (217.56±20.94) mL and postoperative incision pain score (2.06±0.34) in the observation group were lower than that in the control group (298.29±24.85) mL and (5.92±1.08) points, the postoperative drainage (420.29±30.42) mL in the observation group was higher than that in the control group (310.35±24.76) mL, and the hospitalization time of the observation group (5.14±1.03) was shorter than that in the control group (8.25±1.48)d, the incidence of postoperative complications (2.86%) in the observation group was lower than that in the control group (11.43%), and the difference between the two groups was significant and statistically significant (P<0.05). Conclusion Compared with the posterolateral hip approach, the direct anterior approach of lateral DAA in total hip replacement in patients with femoral neck fracture is more effective, which causes less damage to the patient's body, causes less postoperative pain, and ensures adequate drainage and faster postoperative recovery.

Key words: femoral neck fracture, total hip replacement, posterolateral approach to the hip, lateral decubitus direct anterior approach