Hip fracture — MCCQE Part 1 MCQ

Correct answer: D — Provide analgesia, obtain hip radiographs and arrange orthopaedic admission

Provide analgesia, obtain hip radiographs and arrange orthopaedic admission is best because classic deformity after a fall suggests hip fracture. Treat with topical therapy only despite systemic or red-flag features is suboptimal because local treatment alone is inadequate when systemic disease is possible; Delay assessment for several months is suboptimal because red-flag musculoskeletal or dermatologic presentations require timely assessment; Use antibiotics for every presentation is suboptimal because many rashes and painful joints are inflammatory, malignant or mechanical rather than bacterial; Provide opioids or reassurance as the sole management is suboptimal because symptom relief alone does not address diagnosis, function or safety. Early surgery and delirium prevention improve outcomes.

Reference: Canadian Orthopaedic Association guidance