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Orthopaedic Surgery

Answer 2
  1. Hemiarthroplasty. The displaced nature of the fracture will disrupt the blood supply to the femoral head, and, therefore, acceptable healing is not anticipated. Nonsurgical management in a functioning patient who was able to ambulate prior to the fracture can result in fracture malunion or nonunion, in addition to an unacceptable increase in morbidity and mortality. Nonsurgical management is reserved for nonambulators with minimal pain. Traction does not provide definitive care nor does it significantly contribute to pain control preoperatively. Closed reduction does not provide definitive care, and bed rest will result in an unacceptable increase in morbidity and mortality in patients who were previously functional. In this type of patient, open reduction and internal fixation is the treatment option for displaced intertrochanteric hip fractures, not displaced femoral neck fractures. Open reduction and internal fixation can be considered in young adult patients in an effort to preserve the anatomy.

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