A 60- years old man fell in the bathroom and was unable to stand, on right buttock region ecchymosis with external rotation of the leg and lateral border of foot touching the bed. The most probable diagnosis is –
**Core Concept**
The patient's presentation of ecchymosis on the right buttock region, external rotation of the leg, and lateral border of the foot touching the bed is suggestive of a hip fracture, specifically a posterior dislocation of the hip joint. This injury typically occurs due to a fall from a standing height, causing the femoral head to dislocate posteriorly.
**Why the Correct Answer is Right**
The mechanism of injury involves a combination of hip flexion, internal rotation, and adduction, leading to a posterior dislocation of the femoral head. The external rotation of the leg and the position of the lateral border of the foot touching the bed are classic signs of this injury. The patient's inability to stand and the presence of ecchymosis in the right buttock region further support this diagnosis.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as it does not accurately describe the patient's presentation. A hip dislocation would not typically result in ecchymosis on the buttock region.
**Option B:** This option is incorrect as it does not account for the specific mechanism of injury and the resulting position of the patient's leg.
**Option C:** This option is incorrect as it is not directly related to the patient's presentation and the mechanism of injury.
**Clinical Pearl / High-Yield Fact**
In cases of suspected posterior dislocation of the hip joint, it is essential to avoid attempting to reduce the dislocation, as this can further exacerbate the injury and lead to complications.
**Correct Answer:** D.