Dr. Johnstone might consider internal fixation over total hip replacement for Mrs. Gwynn because she is a frail 85-year-old with severe osteoporosis. Internal fixation would repair her femoral neck fracture but not improve her mobility, which is less critical given her condition. Additionally, this option has a shorter recovery time, is less expensive, and involves a less strenuous recovery period compared to total hip replacement.

Given Mrs. Gwynn's advanced age and frailty, along with her severe osteoporosis, Dr. Johnstone may prioritize her immediate health and recovery over potential mobility improvements that a total hip replacement might offer. Internal fixation is a suitable choice as it addresses the fracture effectively while minimizing the risks associated with more invasive surgery. This approach aligns with her current health status and financial considerations, making it a more appropriate treatment option.

Key points

Mrs. Gwynn is 85 years old and frail.
She has severe osteoporosis, complicating surgery options.
Internal fixation repairs the fracture but does not enhance mobility.
This procedure has a shorter recovery time and is less expensive.
Total hip replacement is typically more suitable for younger, healthier patients.

Why might Dr. Johnstone consider internal fixation over total hip replacement for Mrs. Gwynn's treatment?

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