# Hip Fx vs Hip dislocation...



## Pneumothorax (Mar 12, 2011)

i had a call today for an 87 y/o F GLF.
Upon examining her i noticed that her Left leg was bent and she couldnt straighten it, & when i checked her pelvis i felt a protrusion. (that wasnt on the R side)

now i know when a pt has a hip fx the leg is shortened and externally rotated. 

i didnt notice that on her today but i did find it odd that it wouldnt straighten out.

so my question: how does a dislocated leg present itself?


----------



## rescue99 (Mar 13, 2011)

Pneumothorax said:


> i had a call today for an 87 y/o F GLF.
> Upon examining her i noticed that her Left leg was bent and she couldnt straighten it, & when i checked her pelvis i felt a protrusion. (that wasnt on the R side)
> 
> now i know when a pt has a hip fx the leg is shortened and externally rotated.
> ...



Could be either or both. Films will confirm.


----------



## Pneumothorax (Mar 13, 2011)

rescue99 said:


> Could be either or both. Films will confirm.



yeah that what i figured. i just didnt know if there was a particular way dislocations present (most of the time)

i wish i was a human xray lol


----------



## johnmedic (Mar 13, 2011)

GLF? Geriatric living facility?

Dislocations often present with shortening & rotation as well. Pelvic fractures are easy sometimes because of the intense pain, but dislocations can be more subtle. I couldn't determine from your post if the patient was in pain, but depending on your protocols a little manual traction can be great to rule out dislocation vs fracture vs pre-existing situation. Unilateral protrusions & limited range of motion can also be old fractures, hip replacements, arthritis.. among other things so it's hard to say.


----------



## Pneumothorax (Mar 14, 2011)

johnmedic said:


> GLF? Geriatric living facility?
> 
> Dislocations often present with shortening & rotation as well. Pelvic fractures are easy sometimes because of the intense pain, but dislocations can be more subtle. I couldn't determine from your post if the patient was in pain, but depending on your protocols a little manual traction can be great to rule out dislocation vs fracture vs pre-existing situation. Unilateral protrusions & limited range of motion can also be old fractures, hip replacements, arthritis.. among other things so it's hard to say.




she was in pain about 8/10 howling like a coyote.

GLF= ground level fall -lol sorry. i get carried away with abbreviations sometimes.

her pelvis was stable so i dont think it was fx. only xray will tell.


thanks for the info!.


----------



## mycrofft (Mar 14, 2011)

*Hip points (ouch)*

A hip dislocation can occasionally spontaneously slip back, especially immediately after the insult. Mech of injury is usually _LANDING on the outstretched leg_, unless it is an artificial hip joint. Hip fx, which as you know is actually at the proximal neck of the femur, can occur from landing, but more frequently in older folks is from direct impact to the proximal femur from a lateral direction...or being front seat passenger without seat belts in a front-on collision with knee impacts to dashboard.

Pelvis fx is not ruled out without radiography, but assessment in the field will reveal those needing mui quick-quick tx. 

People refer to the pelvis as the hip bone, but it's more the "booty bone", bikini bone", and "baby bone".


----------

