What is the recommended surgical treatment for displaced femoral neck fractures?

The recommended surgical treatment for displaced femoral neck fractures is total hip arthroplasty (THA). This approach is often chosen for several key reasons. First, displaced fractures in the femoral neck frequently lead to complications such as non-union or avascular necrosis, particularly in older patients or those with significant comorbidities. Total hip arthroplasty provides a durable, stable solution that addresses both the fracture and any degenerative changes present in the hip joint.

In cases where joint surfaces are affected, THA replaces not only the fractured neck of the femur but also the acetabulum if it is compromised, which can enhance joint function and alleviate pain more effectively than other treatments. Additionally, studies have shown that THA for such fractures can lead to improved long-term outcomes regarding mobility and quality of life.

While hemiarthroplasty and open reduction with internal fixation might be considered depending on specific patient factors and the fracture's characteristics, they generally do not provide the same level of functional improvement and can carry a higher risk of complications in the context of displaced femoral neck fractures. Conservative management is also not advisable for displaced fractures since it can lead to prolonged pain and disability due to the failure of the fracture to unite properly.