## **Core Concept**
The management of a femoral neck fracture depends on several factors, including the patient's age, the time elapsed since the fracture, the displacement and angulation of the fracture, and the patient's overall health. In elderly patients, the goal is to achieve early mobilization and minimize complications.

## **Why the Correct Answer is Right**
For a one-week-old femoral neck fracture in a 65-year-old patient, the treatment of choice often involves surgical intervention to ensure proper alignment and to facilitate early mobilization, thereby reducing the risk of complications such as nonunion, avascular necrosis, and pressure sores. **Hemiarthroplasty (option C)** is considered in cases where the fracture is displaced or the patient's bone quality is poor, making it difficult to achieve stable fixation. Given the patient's age and the fracture being one week old, hemiarthroplasty allows for immediate weight-bearing and reduces the risk of complications associated with prolonged bed rest.

## **Why Each Wrong Option is Incorrect**
- **Option A (Non-operative management)**: This approach is generally reserved for nondisplaced or minimally displaced fractures in younger patients or those with significant comorbidities that make surgery risky. Given the patient's age and the potential for complications, non-operative management is not the best choice for a one-week-old fracture.
- **Option B (Closed reduction and internal fixation)**: While this is a reasonable approach for nondisplaced or minimally displaced fractures, it might not be the best option for a 65-year-old patient with a one-week-old fracture if there's significant displacement or poor bone quality, as it may not provide the most stable construct for early mobilization.
- **Option D (Total hip replacement)**: Although total hip replacement can be considered for femoral neck fractures, especially in elderly patients with pre-existing hip disease, it might not be the immediate go-to for a one-week-old fracture without mention of pre-existing conditions or more severe joint disease.

## **Clinical Pearl / High-Yield Fact**
A key consideration in the management of femoral neck fractures in the elderly is the high risk of **avascular necrosis** and **nonunion**. Early surgical intervention, such as hemiarthroplasty, can mitigate these risks by providing a stable construct that allows for early mobilization.

## **Correct Answer:** .