Dr. Turner: A 78-year-old woman fell in her home, experiencing sudden and severe pain in the right hip. She arrived by ambulance at the Massachusetts General Hospital approximately two hours after her fall.
Physical examination showed the right leg to be held in external rotation of 80° and to be shortened 1 1/2 inches. There was pain on any attempted motion of the right hip, which obviously was broken. General physical examination showed a blood pressure of 160/85 mm Hg. and there was a grade 1 systolic aortic murmur consistent with minimal arteriosclerotic cardiovascular disease. The lungs, abdomen, and extremities were normal except for the mentioned deformity in the right leg. X-ray films revealed a fracture of the right hip with four-fragment comminution (Fig 1). The femoral head and neck were a single fragment with a long medial spike. The lesser and the greater trochanter were both separate and completely
Aufranc OE, Jones WN, Turner RH. Severely Comminuted Intertrochanteric Hip Fracture. JAMA. 1967;199(13):994–997. doi:10.1001/jama.1967.03120130080016