Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute right hip pain following a mechanical fall. Reports inability to bear weight on the right lower extremity. Denies numbness, tingling, or distal neurovascular deficits. Pain is localized to the proximal thigh, exacerbated by movement.
Clinical Examination Findings
Right lower extremity demonstrates external rotation and shortening. Significant tenderness to palpation over the subtrochanteric region. Range of motion of the right hip is severely limited by pain. Distal pulses (dorsalis pedis and posterior tibial) are palpable and symmetric. Capillary refill < 2 seconds. Sensation intact to light touch in all dermatomes.
Treatment Protocol
Immobilization of the right lower extremity. Immediate orthopedic surgery consultation for open reduction and internal fixation (ORIF) with cephalomedullary nail. Pain management initiated with IV analgesics. NPO status for potential surgical intervention. Prophylactic anticoagulation ordered per protocol.