Fast Five Quiz: Can You Properly Address Hip Fractures?

James W. Pritchett, MD

Disclosures

May 20, 2016

Findings during the physical evaluation of a patient with hip fracture may include:

  • Testing reveals a painful hip with limited range of motion, especially in internal rotation.

  • Pain is noted upon attempted passive hip motion. The heel percussion test also produces pain. Placing a tuning fork over the affected hip may also produce pain.

  • Ecchymosis may or may not be present.

  • An antalgic gait pattern may be present.

  • Deep palpation in the inguinal area produces discomfort. Tenderness to palpation is noted over the femoral neck. This area may also be swollen.

  • Increased pain on the extremes of hip rotation, an abduction lurch, and an inability to stand on the involved leg may indicate a femoral neck stress fracture. If a femoral neck stress fracture is suggested, it must be excluded. Missing this diagnosis could lead to a completely displaced femoral neck fracture, AVN, nonunion of the bone, and eventual varus deformity.

For more on the presentation of hip fracture, read here.

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