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Displaced intracapsular hip fracture — DGM MCQ

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HardFallsDisplaced intracapsular hip fractureDGM

An 88-year-old woman in a care home has an unwitnessed fall and severe left hip pain. Her left leg is shortened and externally rotated, oxygen saturation is 94% and she is taking apixaban for atrial fibrillation. Pelvic X-ray confirms a displaced intracapsular neck of femur fracture. What is the most appropriate management?

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Correct answer: C — Admit under a hip fracture programme with prompt analgesia and orthogeriatric review

A displaced intracapsular hip fracture in a frail older adult requires urgent hospital management within a coordinated hip fracture programme, including analgesia, delirium prevention and orthogeriatric input. Anticoagulation affects perioperative planning but does not make outpatient care appropriate. Hip fracture care is a rehabilitation pathway as well as an operation.

Reference: NICE CG124