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Hip fracture management — DGM MCQ

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EasyFallsHip fracture managementDGM

An 84-year-old woman is admitted after a fall with a shortened externally rotated left leg. X-ray confirms an intracapsular fractured neck of femur. She is haemodynamically stable and had breakfast six hours ago. Current medicines include apixaban for atrial fibrillation. What is the most appropriate management?

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Correct answer: E — Urgent orthogeriatric assessment with early hip-fracture surgery planning

A hip fracture requires urgent admission under a hip fracture pathway with orthogeriatric input, analgesia and early surgery planning. Outpatient follow-up, prolonged delay and definitive traction are inappropriate; high-dose NSAIDs are poor first-line analgesia in frail older adults. The practical priority is coordinated peri-operative optimisation rather than simply arranging orthopaedic review.

Reference: NICE CG124