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A novel diagnostic sign of hip fracture mechanism in ground level falls: two case reports and review of the literature.
Abstract
ABSTRACT:
INTRODUCTION
Most elderly hip fractures are the result of a ground level fall. Defining high risk falls and fracture mechanisms are important
to develop successful hip fracture prevention programs. This case series presents a previously unreported diagnostic sign
and for the first time documents a hip fracture mechanism for a knee impact injury from a ground level fall in two elderly
patients.
CASE PRESENTATION
Case 1 was a 65-year-old Caucasian woman who fell forward with initial contact to her left knee, sustaining an impacted femoral
neck fracture of her ipsilateral left hip. Case 2 was a 92-year-old Caucasian woman who fell bending forward, impacting her
left knee and sustaining a comminuted intertrochanteric fracture of her ipsilateral left hip. The fractures occurred as a
result of unprotected ground level falls in a forward direction with initial impact to the knee. The knee contusions were
located near Gerdy's tubercle and appear characteristic of a direct impact injury.
CONCLUSION
The physical finding of a small localized site of impact and/or contusion in the anterior aspect of the knee in both of these
patients with radiographic evidence of an ipsilateral hip fracture would strongly suggest that a knee impact injury can transmit
enough energy to the proximal femur by axial loading to result in the hip fracture. The physical finding described is a reliable
indicator of this hip fracture mechanism.
Links
Authors
Institution
5501 North 19th Avenue, Suite #432, Phoenix, AZ, 85015, USA. drdougk@aol.com.
Source
Journal of medical case reports 6:1 2012 pg 136Pub Type(s)
Journal ArticleLanguage
eng
PubMed ID
22643013