How does a fractured hip present?

How does a fractured hip present?

• A. Hip pain; leg shortened; externally rotated
• B. Pain in the shoulder; arm adducted; externally rotated
• C. Swelling of the knee; leg lengthened; internal rotation
• D. No pain; stable hip; no deformity

Answer: (A)

Fractured hip presents with severe hip or groin pain after a fall, and the leg often appears shortened and lies in an externally rotated position. The shortening occurs because the fractured femoral neck allows the leg to pull upward, while the external rotation results from the pull of the surrounding muscles and the shape of the joint. This combination—pain in the hip or groin plus a shortened, externally rotated leg—is the classic clue that prompts urgent evaluation and imaging for a hip fracture. Other options describe injuries to different joints or noninjury scenarios: pain in the shoulder with the arm adducted and externally rotated points to a shoulder issue rather than the hip; knee swelling with a lengthened leg and internal rotation doesn’t match the typical hip fracture pattern; no pain with a stable hip would be inconsistent with a fracture, which is almost always painful and unstable.

Fractured hip presents with severe hip or groin pain after a fall, and the leg often appears shortened and lies in an externally rotated position. The shortening occurs because the fractured femoral neck allows the leg to pull upward, while the external rotation results from the pull of the surrounding muscles and the shape of the joint. This combination—pain in the hip or groin plus a shortened, externally rotated leg—is the classic clue that prompts urgent evaluation and imaging for a hip fracture.

Other options describe injuries to different joints or noninjury scenarios: pain in the shoulder with the arm adducted and externally rotated points to a shoulder issue rather than the hip; knee swelling with a lengthened leg and internal rotation doesn’t match the typical hip fracture pattern; no pain with a stable hip would be inconsistent with a fracture, which is almost always painful and unstable.