Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe right thigh pain following a low-energy mechanism (e.g., ground-level fall). History significant for known osteoporosis. Patient denies high-energy trauma. Pain is localized to the right femur, exacerbated by movement and weight-bearing. No prior history of fracture at this site.
Clinical Examination Findings
General: Patient in acute distress due to pain. Right lower extremity: Obvious deformity, shortening, and external rotation of the right femur. Significant tenderness to palpation over the mid-shaft/proximal femur. Neurovascular status: Distal pulses (dorsalis pedis/posterior tibial) intact; capillary refill < 2 seconds; sensation intact to light touch in all dermatomes; motor function limited by pain.
Treatment Protocol
Immediate immobilization of the right lower extremity with a traction splint or long-leg splint. Pain management initiated with IV analgesics. Radiographic imaging (AP/Lateral right femur) confirms pathological fracture consistent with osteoporotic bone. Orthopedic consultation requested for surgical stabilization (ORIF/IM nailing). NPO status for potential urgent surgical intervention.