Common Fracture With Unusual Associated Vascular Injury

Dr. Richard Wohl: An 80-year-old female fell two days before her admission to the emergency ward at the Massachusetts General Hospital. Ten years previously she had suffered a cerebrovascular accident which caused a hemiparesis of the right side. She used a cane for assistance when walking. Except for mild hypertensive cardiovascular disease, she had no other serious illnesses.

Physical examination revealed a moderately obese elderly female with a hemiparesis of the right side; she was in moderate distress due to pain in her right hip. With the exception of motor weakness and increased deep tendon reflexes on the right side, her general physical condition was unremarkable. However, shortening and external rotation of the right leg were noted. She complained of pain with all motions of her hip. Although both femoral and popliteal pulses were thought to be palpable bilaterally, the right popliteal pulse was recorded as only 1+. Both feet