<p><strong>Background: </strong>A prospective study was done to compare the outcomes of management of fracture neck of femur by cemented hemiarthroplasty using modified Hardinge approach and conventional posterior approach<strong></strong></p><p><strong>Methods:</strong> The 2019 to 2022 50 patients underwent bipolar hemiarthroplasty for femoral neck fracture. Group A (Femoral neck fracture treated using conventional posterior approach) and group B (Femoral neck fracture treated using modified Hardinge approach) with 25 patients in each group. Outcomes were evaluated based on mean surgical time and Harris hip score and SF-36.</p><p><strong>Results:</strong> Mean duration of surgery in minutes was more for modified Hardinge approach. Harris hip score with standard deviation for modified Hardinge Approach for follow-ups was better and statistically significant than posterior approach. Similarly, quality of life after surgery, in terms of mean SF-36 score with standard deviation for modified Hardinge approach was better and statistically significant than posterior approach. Modified Hardinge approach has fewer complications in comparison to the posterior approach. With the advantages comes a longer learning curve to operate without complications. Hence, with proper surgical technique, and proper tight closure, we prefer the modified Hardinge approach over other approaches as it had nil dislocations and abductor lurch.</p><p><strong>Conclusions:</strong> Modified Hardinge approach for hip arthroplasty in elderly people with femoral neck fracture provide significant benefit in the early post operative period when compared to conventional posterior approach in terms of post operative pain, time of recovery, dislocation rate and quality of life.</p>

<p><strong>Background: </strong>A prospective study was done to compare the outcomes of management of unstable intertrochantric femur fractures in elderly by hemiarthroplasty and osteosynthesis by proximal femoral nail.<strong></strong></p><p><strong>Methods: </strong>This was an interventional prospective study.<strong> </strong>The study was carried out over 3 years from 2019 to 2022 at PCMC’s PGI YCMH, Pimpri, Pune, Maharashtra, India<strong>. </strong>The study was carried out over 3 years from 2019 to 2022;50 Patients were randomly divided into two groups; Group A (unstable intertrochanteric femur fracture patients treated by bipolar hemi-arthroplasty) and Group B (unstable intertrochanteric femur fracture patients treated by proximal femoral nailing) with 25 patients in each group. Outcomes were evaluated based on functional outcomes, mean surgical time, mean blood loss during surgery, post-operative length of stay, post-operative complications. Harris hip Score was used to assess clinical functional outcomes.<strong></strong></p><p><strong>Results: </strong>The PFN group showed a better Harris Hip score at 1, 3, and 6 months follow ups.<strong> </strong>Mean surgical time was more in bipolar hemiarthroplasty group. Mean blood loss during surgery was more in bipolar hemiarthroplasty group. Post-operative length of stay was more in bipolar hemiarthroplasty group. Post-operative complications like infections, limb length discrepencies were more in bipolar hemiarthroplasty group, whereas 2 implant failures occurred in PFN group compared to a single one in bipolar hemiarthroplasty group.<strong></strong></p><p><strong>Conclusions: </strong>Both PFN and bipolar-hemiarthroplasty appear to produce satisfactory outcomes in surgically treated unstable IT fractures, bipolar-hemiarthroplasty has the advantages of early mobilization and early weight bearing, no risk of non-union but PFN group is superior when it comes to functional outcomes, mean surgical time, Mean blood loss during surgery, post-operative length of stay, post-operative complications.<strong></strong></p>