Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe right hip pain following a mechanical fall from standing height. Reports inability to bear weight on the right lower extremity. Pain is localized to the groin and lateral hip, exacerbated by movement or attempted weight-bearing. No history of prior hip surgery. Denies numbness, tingling, or distal neurovascular deficits.
Clinical Examination Findings
Right lower extremity demonstrates characteristic shortening and external rotation. Significant tenderness to palpation over the greater trochanter and groin. Range of motion of the right hip is severely limited by pain. Distal neurovascular exam: dorsalis pedis and posterior tibial pulses are 2+ and symmetric; capillary refill < 2 seconds; sensation intact to light touch in all dermatomes; motor function intact in distal muscle groups.
Treatment Protocol
Admit for surgical management of closed intertrochanteric fracture of the right hip. Maintain NPO status for urgent operative intervention. Initiate DVT prophylaxis per protocol. Pain management via multimodal analgesia. Obtain preoperative clearance and imaging as indicated. Plan for internal fixation (e.g., cephalomedullary nail or sliding hip screw).