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Displaced intracapsular NOF fracture — MCCQE Part 1 MCQ

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ModerateFractures/TraumaDisplaced intracapsular NOF fractureMCCQE Part 1

A 75-year-old woman falls and presents with shortened externally rotated left leg and groin pain. Cannot weight-bear. XR: displaced subcapital femoral neck fracture. Previously independently mobile. Most appropriate surgical management?

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Correct answer: C — Hemiarthroplasty or total hip arthroplasty

Displaced intracapsular NOF fracture in elderly: arthroplasty preferred. Internal fixation has 20-40% AVN/non-union rates due to disrupted blood supply. Surgery within 48h reduces mortality.

Reference: Canadian Orthopaedic Association Hip Fracture Guidelines