1) Finding of above picture
a) The left hip is externally rotated
b) Shortening of left lower limb
c) Could not extend the hip (need to support with pillow-most probably due to pain)
2) Possible diagnosis
a) The most probable diagnosis is Left Femoral neck fracture secondary to trauma (old age, woman, shortening of lower limb)
b) Left Anterior Hip dislocation secondary to trauma (externally rotated)
3) Management for the patient
a) Set large bore IV line
b) Pain killer (IV Morphine 5 mg+ metaclopromide 10mg. avoid NSAID as old age, but can consider celecoxib [celebrex])
c) Immobalize the leg with immobilizer
d) Search for any other trauma or possible bleeding.
e) Resus patient with crystalloid if significant blood loss is suspected
f) X ray of the hip to exlude dislocation and see the location of injury (Intraarticular vs extra articular) or exclude hip fracture
g) Reduction and traction under analgesic (fentanyl) # External fixation only, not internal fixation.
10) May be required surgery
For more information and complete info on fracture of neck femur, can visit [here]