Subcutaneous ecchymosis on the outside of the hip
Introduction
Introduction Local pain, swelling, tenderness and dysfunction after trauma are obvious. Sometimes the subcutaneous blood spots are visible on the lateral side of the hip. After the injury, the limbs are restricted in activity and cannot stand and walk. Subcutaneous hemorrhagic blood spots on the lateral side of the hip are a clinical manifestation of intertrochanteric fractures. Intertrochanteric fractures are common injuries in the elderly, and the average age of patients is 5 to 6 years older than patients with femoral neck fractures. Due to the rich blood supply in the trochanter, there is very little non-union after fracture, but hip varus is prone to occur. Long-term bed rest in older patients causes more complications.
Cause
Cause
Most of the fractures are caused by indirect external forces. Sudden twisting of the lower limbs, strong adduction or abduction when falling, or direct external impact can occur. Due to the fragility of local osteoporosis, fractures are mostly comminuted. Old people have loose bones, and when the lower limbs suddenly twist and fall, they are easy to cause fractures. Due to the inversion of the trochanter, the hip varus deformity is caused.
Examine
an examination
Related inspection
CT examination of bone and joints and soft tissue serum osteocalcin (BGP)
First, clinical manifestations:
1. Local pain, swelling, tenderness and dysfunction after trauma are obvious. Sometimes the subcutaneous blood spots are visible on the lateral side of the hip. After the injury, the limbs are restricted in motion and cannot stand and walk.
2. The large trochanter is swollen, tender, and the injured limb is shortened. The distal fracture segment is in the extreme external rotation position, and the severe one can reach 90° external rotation. Can also be accompanied by adduction malformations.
Second, the diagnosis basis:
1. Have a history of trauma.
2. The above clinical symptoms and signs: pain, tenderness, external rotation deformity and the like.
3. X-ray film can be seen fracture.
Diagnosis
Differential diagnosis
Differential diagnosis of subcutaneous hemorrhage can be seen on the lateral side of the hip:
1, lateral hip swelling and tenderness: lateral hip swelling, tenderness is one of the clinical diagnosis of femoral intertrochanteric fractures. Intertrochanteric fractures occur mostly in the 66 to 76 years old. The incidence of women is three times higher than that of men. Griffin and Boyd's study of 300 cases of intertrochanteric fractures showed that the mortality rate of patients within 3 months after injury was 16.7%, which was about twice the mortality rate of patients with femoral neck fractures. The reason for such a high case fatality rate is that the patient is older; the fracture causing the fracture is heavier; the blood loss after the fracture is large; the treatment is relatively large. It can be seen that the intertrochanteric fracture is a more serious fracture.
2, lateral hip soreness: lateral hip soreness CT examination is the clinical symptoms of lumbar disc bulging. Lumbar disc bulging: refers to the intervertebral disc, annulus fibrosus, posterior longitudinal ligament without obvious damage, but due to the tension of the lumbar muscles, the intervertebral disc is more stressed, so that the posterior longitudinal ligament bulges backward.
3, lateral hip swelling and tenderness: lateral hip swelling, tenderness is one of the clinical diagnosis of femoral intertrochanteric fracture. Intertrochanteric fractures occur mostly in the 66 to 76 years old. The incidence of women is three times higher than that of men. Griffin and Boyd's study of 300 cases of intertrochanteric fractures showed that the mortality rate of patients within 3 months after injury was 16.7%, which was about twice the mortality rate of patients with femoral neck fractures. The reason for such a high case fatality rate is that the patient is older; the fracture causing the fracture is heavier; the blood loss after the fracture is large; the treatment is relatively large. It can be seen that the intertrochanteric fracture is a more serious fracture.
First, clinical manifestations:
1. Local pain, swelling, tenderness and dysfunction after trauma are obvious. Sometimes the subcutaneous blood spots are visible on the lateral side of the hip. After the injury, the limbs are restricted in motion and cannot stand and walk.
2. The large trochanter is swollen, tender, and the injured limb is shortened. The distal fracture segment is in the extreme external rotation position, and the severe one can reach 90° external rotation. Can also be accompanied by adduction malformations.
Second, the diagnosis basis:
1. Have a history of trauma.
2. The above clinical symptoms and signs: pain, tenderness, external rotation deformity and the like.
3. X-ray film can be seen fracture.
