A 72-year-old woman sustains a Garden Stage III displaced intracapsular femoral neck fracture. She is independently mobile with no cognitive impairment. Which implant strategy offers the best functional outcome and lowest reoperation rate?
- A Cannulated cancellous screws (3-screw fixation)
- B Dynamic hip screw with side plate
- C Total hip arthroplasty (THA) ✓
- D Unipolar hemiarthroplasty
Explanation
For a physiologically fit, independently ambulant patient with a displaced intracapsular femoral neck fracture, total hip arthroplasty provides superior long-term function, lower dislocation rate than hemiarthroplasty, and lower reoperation rate than internal fixation (which has 20–40% failure rate in displaced Garden III/IV due to avascular necrosis and non-union). NICE 2023 guidelines and SIGN recommend THA for patients who walked independently before injury and are not severely cognitively impaired. Hemiarthroplasty is preferred for frail or cognitively impaired patients to reduce surgical time and dislocation risk.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.