Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of right hip/thigh pain following a mechanical fall. History of right total hip arthroplasty (THA) performed [Date/Years ago]. Patient reports inability to bear weight on the right lower extremity. Denies neurovascular deficits, fever, or chills. Pain is localized to the proximal/distal femoral shaft, exacerbated by movement.
Clinical Examination Findings
Right lower extremity: Significant swelling and ecchymosis noted over the lateral thigh. Tenderness to palpation along the femoral shaft. Range of motion of the right hip is severely limited by pain. Neurovascular status: Distal pulses (DP/PT) are palpable and symmetric. Capillary refill < 2 seconds. Sensation intact to light touch in all dermatomes. No motor deficits in the foot or toes.
Treatment Protocol
Immediate immobilization of the right lower extremity. Radiographic imaging (AP/Lateral hip and femur) obtained to classify fracture (Vancouver classification). Orthopedic trauma consultation for surgical stabilization/revision arthroplasty. Pain management initiated with IV analgesics. NPO status for potential urgent surgical intervention. Deep vein thrombosis (DVT) prophylaxis ordered.