Femoral neck fracture - subacute

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Fall one month ago. Ongoing pain left hip.

Patient Data

Age: 80 years
Gender: Female
x-ray

Sclerotic line with lateral cortex disruption of the neck of femur in the subcapital region. 

CT confirms a left subacute subcapital neck of femur fracture that is mildly impacted. 

Fluoroscopy

Image intensifier demonstrates the final position of dynamic hip screw and detorsion screw.

Case Discussion

The patient presented to the emergency department at the time of injury but the fracture was not demonstrated on the x-ray or the subsequent CT (even in retrospect a definite fracture line was not seen). An MRI was not performed. Repeat x-rays four weeks after the initial injury show the fracture clearly - the patient proceeded to ORIF. 

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