A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing):
- [Walking/standing is not possible.]
- Soft tissue damage:
- Bruise marks and hematoma (bruise) usually posterolateral (Lat.: posterior, posterius – posterior; latus – side, flank) to the greater trochanter (large rolling mound; transitional area between the femoral body (corpus femoris) and the femoral neck (collum femoris)).
- Abrasion, wounds in the fracture area (open fracture).
- Malalignment – Shortened leg with external rotation (external rotation) – especially with dislocation (displacement or twisting of bones).
- Previous damage: e.g. infection in the later surgical area and peripheral toes!, scars.
- Inspection (viewing):
- Active and passive motion testing (analgesic administration/painkiller is required before manipulation!):
- [Active lifting of the extended leg not possible.
- Pressure pain over the greater trochanter
- Compression pain triggerable from the heel]
- Vascular testing, neurological status (DMS – blood flow, motor function, sensitivity).
- Determine if there are concomitant/multiple injuries (pelvis, thigh, knee and ankle bilaterally; wrist, shoulder and spine).
- If necessary, internal and neurological examination wg underlying diseases (heart, circulation, lungs, CNS).
Square brackets [ ] indicate possible pathological (pathological) physical findings.
