To date, we have reviewed the synthesis literature critically through four databases: PubMed, Embase, Cochrane Library and Web of Science. Eight relevant studies were examined after compliance with the criteria for inclusion and exclusion, as well as documentation quality evaluation. This report covered all randomised, controlled studies of total hip arthroplasty (THA) comparing the direct anterior approach (DAA) with the postero‐lateral approach (PLA). The main result was surgical site infection rate. The secondary results were duration of the operation, length of the incision and VAS score after surgery. The results of the meta‐analyses of wound infections in the present trial did not show any statistically significant difference in DAA versus PLA (between DAA and PLA) (OR = 1.42, 95%CI: 0.5 to 4.04, p = 0.51). Compared with PLA, DAA had shorter surgical incision (WMD = −3.2, 95%CI: −4.00 to −2.41; p < 0.001) and longer operative times(WMD = 14. 67, 95%CI: 9.24 to 20.09; p < 0.001). Postoperative VAS scores were markedly lower in DAA compared with PLA within 6 weeks of surgery (p < 0.05), with low heterogeneities(I² = 0). We found that DAA did not differ significantly from PLA in terms of the risk of wound infection for THA and that the surgical incisions was shorter and less postoperative pain after surgery, even though DAA surgery takes longer.

Purpose Through the comparative study of femoral neck system (FNS) and 3 cannulated screws (3CS) treatment of femoral neck fracture to analyze the actual clinical efficacy of FNS. Methods A total of 432 patients with femoral neck fractures treated between September 2019 and September 2021 were selected for the study. According to different surgical methods, they were divided into FNS group and 3CS group. The clinical data of the study included intraoperative blood loss, intraoperative fluoroscopy times, duration of surgery, perioperative blood transfusion, postoperative hemoglobin drop, postoperative decreased albumin, and early postoperative complications (lower limb thrombosis, pulmonary embolism, pulmonary infection, urinary tract infection), length of stay, Harris score, and mortality. The above data were statistically analyzed by SPSS 26.0. Results A total of 96 patients were included, followed for 5–10 months, with a mean follow-up of 6.1 months, including 67 in the FNS group and 29 in the 3CS group. The mean age of the FNS group and 3CS group was 58.54 ± 13.85 years and 50.62 ± 18.59 years, respectively, and the difference was statistically significant(P < 0.05). There were no statistically significant differences in gender, laterality, low-energy injury, fracture type, number of underlying diseases, and injury time between FNS and 3CS groups. The duration of surgery the FNS group and the 3CS group were 85.0(50.0) and 72.5(55.5)(min), respectively, the postoperative hemoglobin drop were 15.35 ± 9.60 and 12.05 ± 9.38 (g/L), and the postoperative decreased albumin were 5.97 ± 3.76, 4.81 ± 2.53 (g/L), and the length of stay was 6.0 (3.0), 6.5 (9.0) (d), and there was no significant difference in the above four indicators (P > 0.05). intraoperative blood loss in FNS group and 3CS group were 100(100) and 35(81)(ml) (P < 0.05), respectively, and the intraoperative fluoroscopy times was 8.34 ± 2.87 and 18.66 ± 2.72 (P < 0.001). statistical difference. The average Harris scores of patients in the FNS group at 1, 3, and 6 months after operation were: 47.49 ± 12.18, 67.68 ± 14.51, 84.81 ± 16.72, and the mean Harris scores of patients in the 3CS group at 1, 3, and 6 months after operation were: 55.82 ± 8.86, 69.45 ± 6.92, 86.00 ± 10.78, Harris score was statistically significant at 1 month after operation, and the score in 3CS group was higher (P = 0.02). There was no significant difference in Harris score between the two groups at 3 months and 6 months after operation (P > 0.05). Conclusion Both FNS and 3CS have the advantages of minimally invasive surgery, short hospital stay, and FNS and 3CS have similar curative effects at the 6-month follow-up. In addition, FNS can significantly reduce the number of intraoperative fluoroscopy, which is a feasible method for the treatment of femoral neck fractures.