What is the typical management for a nondisplaced femoral neck fracture in an elderly patient?

• A. Internal fixation with cancellous screws
• B. Hemiarthroplasty
• C. External fixation
• D. Total knee replacement

Answer: (A)

When a femoral neck fracture is nondisplaced in an elderly patient, the priority is to preserve the native hip joint if the bone can heal with stable fixation. These fractures often have intact blood supply to the femoral head, so healing is achievable with proper stabilization. Internal fixation using cancellous screws provides stable compression across the fracture, supports early mobilization, and avoids the higher risk and longevity concerns associated with hip prostheses.

External fixation isn’t appropriate for the hip due to instability and soft-tissue issues, and a total hip replacement is typically reserved for displaced fractures, significant arthritis, or poor bone quality where fixation would likely fail. A hemiarthroplasty can be considered in select cases of displaced fractures or when fixation is unlikely to hold, but for a nondisplaced fracture, preserving the natural joint with screw fixation remains the standard approach.