Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute left hip pain following a mechanical fall. Reports inability to bear weight on the left lower extremity. Denies loss of consciousness, numbness, or paresthesia. Pain is localized to the left groin/lateral hip, exacerbated by any attempted movement.
Clinical Examination Findings
Left lower extremity demonstrates characteristic external rotation and shortening. Significant tenderness to palpation over the greater trochanteric region. Pain elicited with passive range of motion of the left hip. Neurovascular status: Distal pulses (dorsalis pedis/posterior tibial) palpable and symmetric; capillary refill <2 seconds; sensation intact to light touch in all dermatomes.
Treatment Protocol
Initial management includes immobilization of the left lower extremity, pain control, and NPO status in anticipation of surgical intervention. Orthopedic consultation obtained for open reduction and internal fixation (ORIF) with cephalomedullary nail. Prophylactic antibiotics and VTE prophylaxis initiated per protocol.