Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe left hip pain following a mechanical fall from standing height. Patient reports inability to bear weight on the left lower extremity. Pain is localized to the groin and exacerbated by any attempted hip motion. No history of prior hip surgery or trauma.
Clinical Examination Findings
Left lower extremity demonstrates classic deformity: external rotation, abduction, and shortening. Significant tenderness to palpation over the left greater trochanter and groin. Range of motion of the left hip is severely limited and guarded due to pain. Neurovascular status: Distal pulses (dorsalis pedis/posterior tibial) are 2+ and symmetric; capillary refill < 2 seconds; sensation intact to light touch in all dermatomes.
Treatment Protocol
Immediate immobilization and NPO status initiated. Orthopedic surgery consultation for open reduction internal fixation (ORIF) or hemiarthroplasty. Pain management via IV analgesics. Pre-operative workup ordered: CBC, BMP, PT/INR, PTT, EKG, and CXR. Prophylactic antibiotics and DVT prophylaxis per protocol.