Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute right hip pain following a mechanical fall. Reports inability to bear weight on the right lower extremity. Pain is localized to the groin and exacerbated by any attempted movement of the hip. No history of loss of consciousness. Denies numbness or tingling in the distal extremity.
Clinical Examination Findings
Physical examination of the right hip reveals significant tenderness to palpation over the femoral triangle. The right lower extremity is held in a position of external rotation and shortening. Range of motion is severely limited and guarded due to pain. Neurovascular status is intact with palpable dorsalis pedis and posterior tibial pulses; capillary refill < 2 seconds. No sensory deficits noted in the femoral, obturator, or sciatic nerve distributions.
Treatment Protocol
Immediate immobilization and stabilization of the right hip. NPO status initiated in anticipation of surgical intervention. Pain management via intravenous analgesia. Orthopedic surgery consultation for urgent open reduction and internal fixation (ORIF) or hemiarthroplasty as indicated by fracture displacement and patient physiological status. Prophylactic antibiotics and venous thromboembolism (VTE) prophylaxis initiated.