Which sign would most strongly indicate a hip fracture in an elderly patient after a fall?

Which sign would most strongly indicate a hip fracture in an elderly patient after a fall?

• A. External rotation
• B. External rotation and shortening of the leg
• C. Injury to the hand
• D. Numbness in the toes

Answer: (B)

In an elderly patient who has fallen, a hip fracture is most strongly indicated when the leg is both externally rotated and shortened. The fracture disrupts the femoral neck or proximal femur, and muscle forces plus swelling pull the limb into external rotation while the broken bone ends cause the leg to appear shorter. External rotation alone can occur with other injuries and is less specific, while hand injuries or numbness in the toes don’t point to a hip fracture.

In an elderly patient who has fallen, a hip fracture is most strongly indicated when the leg is both externally rotated and shortened. The fracture disrupts the femoral neck or proximal femur, and muscle forces plus swelling pull the limb into external rotation while the broken bone ends cause the leg to appear shorter. External rotation alone can occur with other injuries and is less specific, while hand injuries or numbness in the toes don’t point to a hip fracture.