QuestionSBA
QuestionChoice
This is incorrect. This would generally be used for non-displaced intracapsular fractures and therefore would be inappropriate for this patient.
10027645
e
Cannulated screw fixation
QuestionChoice
This is incorrect. This would generally be used for more stable extracapsular fractures.
10027644
d
Dynamic hip screw
QuestionChoice
This is incorrect. This would be used if the patient had significant comorbidities or was generally less mobile. As the patient is generally well and mobile, she is likely to tolerate a total hip arthroplasty with good outcomes.
10027643
c
Hemiarthroplasty
QuestionChoice
This is incorrect. Although can be useful for pain management it is not the definitive treatment for a neck of femur fracture. She requires surgical intervention; likely a total hip arthroplasty.
10027642
b
Femoral nerve block
QuestionChoice
This is the correct answer. Garden stage IV represents a complete fracture of the femoral neck. As the patient is generally well and mobile, she is likely to tolerate the procedure with good outcomes. A total hip arthroplasty would be used to replace both the femoral head and the acetabulum.
10027641
a
Total hip arthroplasty
Concept
Chapter
2693
3907
fractured neck of femur
Topic
145
Orthopaedics
17926
A 73 year old female is brought into A&E by ambulance following a fall in her garden. She is normally fit and well aside from mild hay fever, and does not use any walking aids. She reports pain in her left hip despite intravenous paracetamol and oramorph. Her left leg appears to be shortened and internally rotated.

An x-ray is taken and a garden stage IV fracture can be seen with displacement.

Which of the following is the definitive management for this patient?
a