Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe left hip pain following a mechanical fall. Reports inability to bear weight on the left lower extremity. No history of prior hip surgery. Denies numbness, tingling, or distal neurovascular deficits.
Clinical Examination Findings
Left lower extremity demonstrates external rotation and shortening. Significant tenderness to palpation over the left subtrochanteric region. Range of motion of the left hip is severely limited by pain. Distal pulses (dorsalis pedis and posterior tibial) are 2+ and symmetric. Capillary refill < 2 seconds. Sensation intact to light touch in all dermatomes.
Treatment Protocol
Diagnosis: Closed subtrochanteric fracture of the left femur (ICD-10: S72.22A). Plan: Immobilization of the left lower extremity, strict non-weight bearing status, pain management, and urgent orthopedic surgical consultation for open reduction and internal fixation (ORIF).