Knee Impact Sign of Kelly and Kelly for Hip Fracture After a Ground Level Fall

Patient selection: older adult with ground level fall

Features:

(1) ground level fall with forward momentum

(2) impact on a bended knee, resulting in an abrasion, contusion or other sign of impact on the anterior knee

A patient with these findings may have an ipsilateral hip fracture (femoral neck, intertrochanteric).

Proposed mechanism: axial loading of fall energy to the proximal femur

While most hip fractures occur from a sideway fall with impact near the hip, this may represent another mechanism.