65-year-old lady falls from height. On examination the leg is extended and externally rotated. Diagnosis is
C i.e. Neck femur fracture Femoral neck is the commonest site of fracture in elderly. The fracture may be intracapsular where the fracture line can vary from middle of the neck to subcapital region (fractre neck femur); or extracapsular where the fracture can be at the very base of neck or through the peritrochenteric line. (fracture interochenteric femur) Fracture of the neck of femur are usually sustained by old people from tril strains such as tripping on a stair or stumbling on a carpetQ It most commonly occur in elderly women. Risk factors are postmenopausal/age related osteoporosis, bone losing or bone weakening disorders such as osteomalacia, diabetes, stroke (disuse), alcoholism, and chronic debilitating disease. Every elderly patient who, after tril injury, complains of pain in the region of hip and lies with the limb in lateral rotation should be assumed to have sustained a fracture of femoral neckQ until radiographs taken in two planes prove other wise. In the extra capsular fractures (interochanteric fracture) there is usually gross deformity and loss of functionQ but in undisplaced intracapsular (neck) fracture patient may still be able to walk, and such ordinary signs of fractures as shoening of the limb seldon develop until after several days or weeks. Quite often with minor displacement the only clinical sign that is obvious is slight lateral rotation deformity and a provisional diagnosis should be made on this evidence aloneQ
Fracture of acetabulum
Interochanteric fracture
Neck femur fracture
Posterior dislocation of hip