Kelly and Kelly correlated a lesion on the knee in a patient with a ground level fall with hip fracture. The authors are from Phoenix, Arizona.

Patient selection: older adult with ground level fall



(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.

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