A 60-year old female had fallen in the bathroom and she is not able to stand on her feet. On examination, her right leg was in external rotation and was not able to move her leg. There was tenderness in Scarpa's triangle. There is no history of fever. X-ray shows no fracture line. What is the next step of management?
Ans. a. MRI (Ref: Apley's 11/848, 849)History of fall followed by tenderness in Scarpa's triangle and leg in externally rotated position is suggestive of fracture neck of femur. An impacted, undisplaced fracture is likely to be missed on an X-ray. An MRl or a bone scan would be needed to diagnose the lesion."Impacted fractures may be extremely difficult to discern on plain X-ray. If there is a fracture it will show up on MRI or a bone scan after few days."- Apley 11/848
MRI
Strict bed rest for 10 days and repeat X-ray
Joint Aspiration
Start proper anlgesia and start mobilization to prevent stiffness
Fracture Neck of Femur