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May 25, 1963

High Femoral Neck Fracture: An illustrative case focusing on the problem of primary prosthetic replacement versus reduction and nailing of femoral neck fractures in the elderly

Author Affiliations


From Massachusetts General Hospital.

JAMA. 1963;184(8):648-651. doi:10.1001/jama.1963.73700210014014

Dr. David Mitchell: On the day of admission, this 81-year-old woman tripped over a stool and fell to the floor, injuring her left hip. She was able to arise and sit in a chair. Shortly thereafter, she got up but was able to walk only about 10 ft because of pain in her left hip. She was taken to the emergency ward of the Massachusetts General Hospital. On examination, the left lower extremity was found to be shortened and to lie in extremity was found to be shortened and to lie in external rotation. Rotation of the extremity produced pain in the hip.

Her medical history was noteworthy in that 40 years previously she had had rheumatic fever and a heart murmur had been present since that time. Five years ago, a diagnosis of hypertension was made. The patient had been treated with reserpine (Serpasil). In addition, she was being treated for glaucoma and had had a peptic ulcer three