Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute right hip and proximal thigh pain following [mechanism of injury]. Reports inability to bear weight on the right lower extremity. Denies numbness or tingling in the distal extremity. No history of prior surgery to the right hip.
Clinical Examination Findings
Right lower extremity demonstrates significant swelling and ecchymosis of the proximal thigh. Right hip held in external rotation and abduction. Tenderness to palpation over the subtrochanteric region. Distal neurovascular status intact: dorsalis pedis and posterior tibial pulses 2+, capillary refill <2 seconds, sensation intact to light touch in all dermatomes.
Treatment Protocol
Immobilization with skeletal traction or splinting. Orthopedic surgery consultation for open reduction and internal fixation (ORIF) with intramedullary nail. Pain management via IV analgesia. NPO status initiated in anticipation of surgical intervention. Prophylactic antibiotics and VTE prophylaxis per protocol.