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Displaced femoral neck fracture — MCCQE Part 1 MCQ

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ModerateFracturesDisplaced femoral neck fractureMCCQE Part 1

A 82-year-old woman falls at home and cannot bear weight. Her left leg is shortened and externally rotated, and radiograph shows a displaced intracapsular femoral neck fracture. She has mild dementia but was walking independently before the fall. What is the most appropriate next step in management?

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Correct answer: B — Admit for analgesia, medical optimisation, and urgent hip fracture surgery

Displaced femoral neck fracture in an older adult requires admission, adequate analgesia, optimisation, and timely operative management to reduce morbidity. Discharge or bed rest would cause pain, immobility complications, and loss of function. A walking boot is irrelevant to a hip fracture. Dementia does not remove the need for appropriate fracture care.

Reference: Canadian Orthopaedic Association hip fracture care guidance