**Question:** True about Rx of fracture neck of femur?

A. Open reduction and internal fixation (ORIF)
B. Total hip arthroplasty (THA)
C. Cast immobilization
D. None of the above

**Core Concept:** Treatment of a fracture neck of femur involves a decision between open reduction and internal fixation (ORIF) and total hip arthroplasty (THA). Cast immobilization is not an appropriate treatment for this type of fracture.

**Why the Correct Answer is Right:**

The correct answer is B - Total hip arthroplasty (THA) because a fracture neck of femur is a severe injury that requires surgical intervention due to its high risk of complications like malunion, nonunion, and avascular necrosis if treated conservatively. THA involves replacing the damaged femoral head and neck with an artificial implant, allowing the patient to regain mobility and reduce pain.

**Why Each Wrong Option is Incorrect:**

A. Open reduction and internal fixation (ORIF) is a surgical procedure that realigns the fracture fragments and stabilizes them with internal fixation devices like screws or pins. Although ORIF is a viable option in specific cases, THA is generally preferred due to its longer-term stability, reduced risk of complications, and improved patient outcomes.

C. Cast immobilization is an inappropriate treatment for a fracture neck of femur as it does not address the instability caused by the fracture and increases the risk of complications.

**Clinical Pearl:**

In the context of fracture neck of femur, it is essential to understand that THA is the preferred treatment option over ORIF and cast immobilization due to its superior long-term stability, reduced complications, and improved patient outcomes. This decision should be made based on factors such as age, general health, and fracture pattern. While both ORIF and THA are surgical interventions, THA is typically favored for its lower risk of complications and superior patient outcomes.