What is the classic presentation of a femoral neck fracture in an elderly patient?

What is the classic presentation of a femoral neck fracture in an elderly patient?

• A. Shortened, externally rotated limb with hip/groin pain.
• B. Pain localized to the knee with swelling.
• C. Absent pulses in the leg.
• D. Fever and erythema over the hip.

Answer: (A)

Recognizing the classic deformity after a fall in an elderly patient is what this item tests: a femoral neck fracture typically presents with a shortened, externally rotated limb and hip or groin pain. The fracture disrupts the alignment of the femoral head and neck, and the muscles around the hip pull the leg into external rotation while gravity makes it appear shorter. Pain is felt in the hip or groin, not the knee, and pulses are usually present because vascular supply isn’t immediately compromised. Other descriptions—knee swelling, absent leg pulses, or fever with hip redness—point to different problems such as knee pathology, vascular issues, or infection rather than a straightforward fracture of the femoral neck.

Recognizing the classic deformity after a fall in an elderly patient is what this item tests: a femoral neck fracture typically presents with a shortened, externally rotated limb and hip or groin pain. The fracture disrupts the alignment of the femoral head and neck, and the muscles around the hip pull the leg into external rotation while gravity makes it appear shorter. Pain is felt in the hip or groin, not the knee, and pulses are usually present because vascular supply isn’t immediately compromised. Other descriptions—knee swelling, absent leg pulses, or fever with hip redness—point to different problems such as knee pathology, vascular issues, or infection rather than a straightforward fracture of the femoral neck.