Femoral neck fracture - basicervical

Case contributed by Leonardo Lustosa
Diagnosis certain

Presentation

Fall from standing height onto her right hip. Shortened and externally rotated right lower limb.

Patient Data

Age: 75 years
Gender: Female

Pelvis and right hip radiographs revealed a basicervical femoral neck fracture.

There is a discrete fracture line at the base of the femoral neck.

The right Shenton line is disrupted, which further indicates a femoral neck fracture (see annotated image below).

Incidental atherosclerosis is noted bilaterally.

Annotated image

Shenton line drawn on both hips. The right Shenton line is disrupted, indicating a femoral neck fracture.

Case Discussion

Using the hip landmarks is a way to systematize and avoid missing more discrete findings.

In the present case, one could miss the right femoral neck fracture. However, if the Shenton line is properly assessed, it would be noticed that it is disrupted on the right, indicating a femoral neck fracture.

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