Case history
Case history
A 72-year-old woman with a preexisting osteoporosis diagnosis and a low body mass index presents with a history of a fall from standing height and an inability to bear weight afterward. She describes pain in her right hip and is in some distress. There were no preceding syncopal episodes and no loss of consciousness or chest pain. Cardiac and pulmonary exam is noncontributory. Her right hip is painful and sore to palpation with some ecchymoses over the greater trochanter. There are no breaks in the skin, and the right leg is shortened and externally rotated. The pelvis is stable clinically, and there is no pain along the spine and no deformity along the femoral shaft, knee, or tibia. The distal neurovascular status is intact.
Other presentations
Usually occurs in patients more than 65 years of age or in those who have osteopenic conditions of bone or osteoporosis. They are generally due to low-energy injuries in this patient group. However, hip fractures may present in those younger patients with high-energy injuries such as motor vehicle accidents and falls from height; these fractures can then be associated with other fractures of the femur and other injuries consistent with polytrauma.
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