How does the leg typically present in a hip fracture?

• A. Lengthened and internally rotated.
• B. Neutral position with no rotation.
• C. Shortened and externally rotated.
• D. Abducted and flexed.

Answer: (C)

The leg is shortened and externally rotated with a hip fracture because the fracture disrupts the normal alignment of the femoral neck or intertrochanteric region, allowing the proximal fragment to displace and rotate outward under the pull of the external rotator muscles. Muscular spasm further contributes to the outward rotation, so the limb appears shorter and rotated away from the midline. This pattern helps distinguish hip fractures from other injuries; for example, a dislocation typically presents with the leg in an internally rotated position, and neutral or non-rotated limb positions are not characteristic of a fracture. In practice, this presentation should prompt urgent evaluation for a hip fracture, with immobilization and imaging as appropriate.