Pelvis Case #2
Jun 02, 2015
Pelvis Case #2
Help I’ve fallen and I can’t get upH&P78 yo WF fall at
home. States she was walking in her house when she lost her balance and fell landing on her left hip. She did not hit her head and denies LOC, but c/o left hip pain
PEVS: Afebrile. P 94,
BP 135/93, Pox 97% RA
Gen: Elderly, thin, appears to be in pain
Ext: LLE hip is TTP and leg appears externally rotated and shortened
Image
Left femoral neck fracture
Pain controlConsider eval for medical causes of fall; ie
MI, dysrythmias, CVAEarly ortho consult Operative management
ED Management
Femoral neck fractures can also be seen in high velocity trauma in younger patient and less commonly as stress fractures in athletes
Hip fractures in the elderly are associated with high mortality in the first year after the injury.
Delay of operative repair greater than 48 hours is also associated with increased mortality
Pearls
Other Images
Davenport, M et al. “Hip Fracture in Emergency Medicine”. Emedicine.com. 9/2010.
Truong, H et al. “Femoral Neck Fracture imaging”. Emedicine.com 5/2011
Tininalli, J et al. “Emergency Medicine: A Comprehensive Study Guide”. 6th ed. 2003
Wheeless, C. “Fracutures of the Femoral Neck”. Wheelessonline.com. 7/2010
References