Comparative Evaluation of Hardinge’s And Moore’s Approaches in the Surgical Management of Femoral Neck Fractures in Elderly Patients

Abstract

Background: Femoral neck fractures are common in the elderly and increasingly managed with hemiarthroplasty. The optimal surgical approach—either the direct lateral (Hardinge’s) or posterior (Moore’s)—remains a subject of debate.

Objectives: This prospective study compares the two approaches regarding perioperative complications, surgical parameters, and functional outcomes.

Methods: Sixty elderly patients with femoral neck fractures were enrolled and treated via either Hardinge’s (n=30) or Moore’s (n=30) approach for bipolar hemiarthroplasty. Outcomes were evaluated using the Modified Harris Hip Score (HHS) at 1, 3, and 6 months postoperatively. Parameters such as duration of surgery, blood loss, dislocation, infection, and abductor strength were analyzed.

Results: The mean HHS scores for the Hardinge group were 36.8, 66.0, and 76.6, while for the Moore group they were 35.9, 63.1, and 73.7 at 4 weeks, 3 months, and 6 months, respectively. Dislocation occurred in one case in the Moore group, whereas the Hardinge group had five instances of abductor weakness. No significant differences were noted in operative time or intraoperative blood loss.

Conclusion: Both approaches provided comparable outcomes in terms of surgical safety and hip function. Hardinge’s approach may reduce dislocation risk, while Moore’s approach appears to better preserve abductor function. Surgical approach selection should be tailored based on individual patient anatomy and surgeon expertise.