Over the holidays, Gramma fell and broke her hip. They say she has a displaced femoral neck fracture. When the surgeon gets back, they will decide whether to fix or replace the hip. She is in pretty good health but slowly declining. What should we opt for?

There isn’t a clear cut answer that can be applied to all older adults with this type of fracture. Many factors must be considered. Once the surgeon reviews the X-rays and examines your grandmother, he or she will be able to give you all of the pros and cons for each one.

In a young, active adult with good bone stock, this type of break can be repaired. The surgeon lines the bones up and holds them together with a metal plate, wires, screws, or pins. When the fracture heals, the fixation pieces may or may not be removed.

If the patient has brittle bones or is wheelchair bound, a total hip replacement (THR) may be the best option. General health and the presence of other conditions such as diabetes or heart disease must be considered.

The surgeon’s own level of experience and training will also factor into the decision. The goals are to relieve pain, restore function, and preserve independence. The surgeon, patient, and family should take these goals into consideration when reviewing each management option.