A 53-Year-Old Man Is Brought to the Emergency Department After

question 422

Multiple Choice

A 53-year-old man is brought to the emergency department after a fall while skiing.  The patient immediately felt severe pain in the right hip and had to be brought down the mountain by ski patrol.  He does not have any other injuries.  Medical history is unremarkable, and the patient does not take any medications.  Blood pressure is 168/94 mm Hg, pulse is 100/min, and respirations are 24/min.  Pulse oximetry is 96% on room air.  On examination, the patient appears uncomfortable and in pain.  The right hip is flexed, displays an obvious deformity, and is tender to palpation.  Hip range of motion is limited, and the right leg is shortened and internally rotated.  Distal pulses are intact.  X-ray of the pelvis is shown in the exhibit.  Which of the following is the best next step in management of this patient?

• A)Admit for pain control and orthopedic consultation in the morning
• B)Closed reduction in the emergency department
• C)Discharge home with crutches and orthopedic follow-up
• D)Obtain a CT angiogram of the right lower extremity
• E)Place a pelvic binder on the patient

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Definitions:

Provident Hospital

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AIDS Virus

Human Immunodeficiency Virus (HIV), which causes acquired immunodeficiency syndrome (AIDS), a condition where the immune system fails, leading to life-threatening infections.

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