A Novel Diagnostic Sign of Hip Fracture Mechanism

                                   http://www.smo.edu.mx/pdf/cursos_cadaver2013.pdf

http://icjr.net/article_25_hip_fracture.htm#.UZOl8LUz2Sp

A Novel Diagnostic Sign of Hip Fracture Mechanism

The authors describe the Knee Impact Sign, which they say is a reliable indicator of hip fracture mechanism in patients who have fallen forward on one knee.

By Douglas Kelly - May 6, 2013

Authors

Douglas W. Kelly and Brian D. Kelly

Introduction

A simple ground level fall can have serious consequences. More than 90% of hip fractures in the older population are the result of a ground level fall [1-4]. Current hip fracture prevention strategies in this age group are based mostly on the prevention of osteoporosis, decreasing the number and severity of falls, and protection of the proximal femur when a fall occurs [5]. Understanding the relationships between fall characteristics and hip fracture mechanisms is critical to developing successful prevention programs.

Investigators studying hip fracture mechanisms have concluded that the most common mechanism of hip fracture in older persons is a sideways fall with lateral hip impact [6-11]. To date there has been no reliable physical finding or radiographic feature on which to base these conclusions or to define fracture mechanisms objectively.

The cases of two patients presenting with a distinct and previously unreported physical finding indicating a hip fracture mechanism are described. An in-depth review of the literature suggests that this is not only a characteristic finding, but one of clinical importance.