Treatment of choice for one week old fracture neck femur at 65 years age is:
**Core Concept**
Nonoperative management of femoral neck fractures, particularly in the elderly, has evolved to prioritize less invasive techniques that minimize complications and improve outcomes. The primary goal is to reduce pain, prevent further fracture displacement, and promote healing.
**Why the Correct Answer is Right**
In a 65-year-old patient with a one-week-old fracture neck femur, the treatment of choice is typically nonoperative management with bed rest, analgesia, and possibly a femoral neck screw or cannulated screw for stabilization. This approach is favored due to the risk of complications associated with surgical intervention, such as osteoporotic bone, potential for nerve injury, and the likelihood of poor bone healing. The nonoperative management allows for the patient to be mobilized early, reducing the risk of deep vein thrombosis and pressure sores.
**Why Each Wrong Option is Incorrect**
**Option A:** Surgical fixation with a hemiarthroplasty is typically reserved for older patients with a high risk of complications, as it carries a higher risk of mortality and morbidity.
**Option B:** Internal fixation with a sliding hip screw may be considered in younger patients with a stable fracture, but in an elderly patient with osteoporotic bone, this option may not be suitable.
**Option C:** Closed reduction with percutaneous pinning is not commonly used in the management of femoral neck fractures, especially in the elderly.
**Clinical Pearl / High-Yield Fact**
It's essential to assess the patient's overall health, mobility, and bone quality before deciding on the treatment approach for femoral neck fractures. A thorough evaluation of the patient's risk factors and comorbidities will help guide the treatment decision.
**Correct Answer:** C. Closed reduction with percutaneous pinning is not commonly used in the management of femoral neck fractures, especially in the elderly.