If a patient with a #NoF (or other fragility fracture requiring admission) has received a head injury requiring CT a CT Neck should also be performed. A #NoF is a fragility fracture hence this patient is at high risk of also sustain C-Spine injury. Also the pain is likely distracting and the patient is often over 65yrs old so Canadian C-Spine rules will not apply.
Why did They Fall? – was this a collapse?
Are they sick? – Co-morbidity/illness is common in this group and must be recognised
Anticoagulants? – This affects treatment
On Warfarin – If INR >1.5 (or unavailable) Vit-K 5mg
Other injuries? – >65’s the most common mechanism of TARN major trauma is fall <2m
Typically – Pain hip/buttock, shortened, externally rotated
Atypical – Few signs (can they lift their leg & is rotation at the hip painful)