A shortened, deformed, painful leg after a motor vehicle accident most likely indicates which injury?

• A. Femur fracture
• B. Patella fracture
• C. Hip dislocation
• D. Tibial fracture

Answer: (A)

A leg that is shortened and visibly deformed after a high-energy injury points to a fracture with displacement, most commonly a femoral shaft fracture. When the femur breaks, the bone ends aren’t aligned and powerful thigh and hip muscles pull the fragments into a new position, producing noticeable shortening of the leg and deformity. This pattern is less typical for a patellar fracture, which mainly causes knee pain and trouble extending the knee; for a hip dislocation the limb is often held in a particular position (often internally rotated and adducted) rather than just appearing deformed along the thigh; and tibial fractures show deformity lower down the leg rather than at the thigh. Thus, the presentation fits best with a femur fracture.