امرأة عمرها ٨٢ سنة سقطت في البيت ولا تستطيع الوقوف. رجلها اليمنى أقصر ودائرة للخارج، وتتألم عند تحريك الورك. تأخذ وارفارين. الضغط ١٤٢/٨٠، والنبض ٩٦. ما الأرجح؟

An 82-year-old woman fell at home and cannot stand. Her right leg is shortened and externally rotated, with pain on hip movement. She takes warfarin. BP 142/80, HR 96. What is most likely?

1. Muscle pain after the fall
2. Shoulder dislocation
3. A simple knee sprain
4. Femoral neck fracture

Answer: D) Femoral neck fracture. A shortened, externally rotated leg with hip pain after a fall in an older woman indicates a femoral neck fracture. Analgesia, imaging and surgery within 24–48 hours are needed, with anticoagulant reversal.