Which physical findings are characteristic of hip fractures?

Updated: Jan 08, 2019
  • Author: Naveenpal S Bhatti, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Answer

Findings of the physical evaluation of the patient with a hip fracture may include the following:

  • Testing reveals a painful hip with limited range of motion, especially in internal rotation.

  • Pain is noted upon attempted passive hip motion. The heel percussion test also produces pain. Placing a tuning fork over the affected hip may also produce pain

  • Ecchymosis may or may not be present.

  • An antalgic gait pattern may be present.

  • Deep palpation in the inguinal area produces discomfort. Tenderness to palpation is noted over the femoral neck. This area may also be swollen.

  • Increased pain on the extremes of hip rotation, an abduction lurch, and an inability to stand on the involved leg may indicate a femoral neck stress fracture. If a femoral neck stress fracture is suggested, it must be excluded. Missing this diagnosis could lead to a completely displaced femoral neck fracture, AVN, nonunion of the bone, and eventual varus deformity.


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