Which presentation is most consistent with a hip fracture?

• A. leg is shortened and internally rotated.
• B. leg lengthened.
• C. leg externally rotated.
• D. no deformity.

Answer: (A)

Hip fracture classically presents with a shortened leg that lies in external rotation. When the femoral neck or intertrochanteric region is fractured, the distal fragment is pulled by the iliopsoas and other external rotators, while the proximal fragment is stabilized by the hip abductors, causing the limb to rotate outward and appear shorter compared with the uninjured side. An internal rotation would point toward a different injury, such as a posterior hip dislocation, and leg lengthening or no deformity would not fit a fracture. So the shortening with external rotation fits the typical pattern of a hip fracture.