Pelvis Case #

Help I’ve fallen and I can’t get upH&P78 yo WF fall at

home. States she was walking in her house when she lost her balance and fell landing on her left hip. She did not hit her head and denies LOC, but c/o left hip pain

PEVS: Afebrile. P 94,

BP 135/93, Pox 97% RA

Gen: Elderly, thin, appears to be in pain

Ext: LLE hip is TTP and leg appears externally rotated and shortened

Image

Left femoral neck fracture

Pain controlConsider eval for medical causes of fall; ie

MI, dysrythmias, CVAEarly ortho consult Operative management

ED Management

Femoral neck fractures can also be seen in high velocity trauma in younger patient and less commonly as stress fractures in athletes

Hip fractures in the elderly are associated with high mortality in the first year after the injury.

Delay of operative repair greater than 48 hours is also associated with increased mortality

Pearls

Other Images

Davenport, M et al. “Hip Fracture in Emergency Medicine”. Emedicine.com. 9/2010.

Truong, H et al. “Femoral Neck Fracture imaging”. Emedicine.com 5/2011

Tininalli, J et al. “Emergency Medicine: A Comprehensive Study Guide”. 6th ed. 2003

Wheeless, C. “Fracutures of the Femoral Neck”. Wheelessonline.com. 7/2010

References