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Hip fracture in older adult — MCCQE Part 1 MCQ

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ModerateFracturesHip fracture in older adultMCCQE Part 1

An 86-year-old woman falls and has a shortened externally rotated leg. X-ray confirms displaced femoral neck fracture; she was previously independently mobile. Which of the following is the most appropriate next step?

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Correct answer: D — Admit for analgesia, medical optimization and early operative management

Displaced hip fracture in an older adult usually requires admission, analgesia, delirium prevention, medical optimization and timely surgery. Prolonged bed rest increases mortality, pressure injury and thromboembolism. Bisphosphonates address future fracture risk but not the acute fracture.

Reference: Canadian Orthopaedic Association; Canadian fragility fracture guidance