These patients need to be admitted and orthopedics consulted to arrange for surgery, typically reduction and fixation or arthroplasty, either total or hemi.  There are no absolute guidelines for which surgical intervention will be performed, but generally speaking, younger patients with non-displaced fractures are candidates for ORIF. Older patients, those with displaced fractures, and those with pre-existing arthritis are generally treated with arthroplasty. The femoral head is essentially avascular from displaced fractures and will be subject to subsequent avascular necrosis and collapse without replacement.