Fixing More Than a Fracture: Multidisciplinary Surgical and Rehabilitation Challenges in a Geriatric Femoral Neck Fracture with Obsessive–Compulsive Disorder

Obsessive–compulsive disorder (OCD) may increase the risk of injury and complicate recovery, especially in the elderly. A man in his 60s with a 40-year history of OCD sustained a right subcapital femoral neck fracture (Garden IV and Pauwels III) after a fall in a psychiatric ward. He underwent uncemented bipolar hemiarthroplasty via the posterior approach. Postoperatively, his Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) score worsened from 19 to 33, with functional decline. A customized rehabilitation program combining graded physiotherapy and exposure-based cognitive behavioral therapy, guided by the Subjective Units of Distress Scale, was initiated. At 3 months, the Y-BOCS score improved to 20 and the Harris Hip Score increased from 23.2 to 82.65. A multidisciplinary, individualized approach integrating psychological support into rehabilitation may enhance both mental health and functional recovery in orthopedic patients with psychiatric comorbidities.