Fracture neck of femur in elderly patients: mechanism of injury and clinical presentation

This descriptive study was conducted in the Department of Orthopaedics, Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar from July 2000 to June 2003 to ascertain the mechanism of injury and clinical presentation of elderly patients with fracture neck of femur. During the study period 119 patients with age 65 years or above who had fracture neck offemur were admitted. However, the complete record of only 98 patients was available. Among these 39 % were males and 61% females, with a female to male ratio of 1.5:1. The average age was 71 years and 71% of the patients had co-morbidities. The most common mechanism of injury was a fall indoor or outdoor without any extrinsic cause in 84.7% of patients. The consistent clinical symptoms were pain in the region of hip or groin and inability to bear weight present in 100% and 96% of patients respectively. The examination findings included tenderness over the greater trochanter and limitations of hip movements. Shortening and external rotation of extremity were not consistent signs being present in only 49% and 37% of patients respectively. Majority of patients [43%] had falls early in the morning