Treatment of choice for one week old fracture neck femur at 65 years age is:
B i.e. Closed reduction & internal fixation Principles, Rationale and Treatment Plane Of Intracapsular Fracture Neck Femur Femoral head should not be sacrificed lightly in every fracture, paicularly when the fracture is undisplaced or can be reduced accurately. Primary prosthetic replacement should be reserved for the very old or infirm, and for pathological, irreducible, or grossly comminuted fractures. (i.e. when preserving head is almost not possible). United femoral neck fracture with an intact head is better than any prosthesis and where there is a reasonable chance of good internal fixation, and accurate reduction can be obtained close reduction and internal fixation should be the treatment of choice. The two main treatment modalities are - ahroplasty (hemi replacement & THR) and reduction and internal fixation by canulated cancellus screws. The prosthetic replacement allows immediate weight bearing & eliminates chances of nonunion and avascular necrosis and in limited life expectancy reduces the chances of reoperation. But the salvage procedures become complicated if there is mechanical failure or infection
Hemi-replacement ahroplasty
Closed reduction and internal fixation by cannulated cancellous screws
Closed reduction and internal fixation by Austin more pins
Total hip replacement