A 75-year-old woman presents with history of tripping and falling in the bathroom and unable to walk or bear weight on her left hip. On examination it was noted that her left lower limb was in an externally rotated position, hip was tender and active straight leg raising was not possible. The most possible diagnosis is:
Correct Answer: Fracture neck of femur
Description: Ans: A (Fracture neck of femur) Ref: Apley's System of Orthopaedics and Fractures, 9th Edition, P 847-848Explanation:Fracture Neck of FemurMost common site of fractures in the elderly.Common in women in the 8th and 9th decades.The association with osteoporosis is main underlying factor.Other risk factors include bone-losing or bone-weakening disorders such as osteomalacia, diabetes, stroke (disuse}, alcoholism and chronic debilitating disease.In addition, old people often have weak muscles and poor balance resulting in an increased tendency to fall.The fracture usually results from a simple fall; how ever, in very osteoporotic people, less force is required--perhaps no more than catching a toe in the carpet and twisting the hip into external rotation.Occasionally, stress fractures of the femoral neck occur in runners or military personnel.Not all hip fractures are so obvious. With an impacted fracture the patient may still be able to walk, and debilitated or mentally handicapped patients may not complain at all-even with bilateral fractures.
Category:
Orthopaedics
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