A Case Report of an Overlooked Femoral Neck Fracture Presenting with Unusual Lower Limb Edema

Abstract

This report describes a case of an elderly woman who presented to the emergency department with unilateral lower limb edema and generalized weakness. A thorough clinical examination and evaluation of underlying causes are essential for accurate diagnosis and timely treatment. The patient, who has a history of chronic illnesses including osteoarthritis and limited mobility necessitating ambulatory assistance, was admitted due to these symptoms. On physical examination, dorsalis pedis and posterior tibial pulses in the right lower limb were markedly diminished and barely palpable. Additionally, severe swelling was observed in the right lower limb extending from above the knee to the toes. The patient was hemodynamically stable upon presentation. In elderly individuals, the risk of fractures following falls is significantly higher due to reduced bone density and increased fragility. A femoral neck fracture, one of the most common types of femoral fractures, typically presents with symptoms such as sudden onset pain after a fall, inability to bear weight, and difficulty walking. Associated findings may include localized bruising or swelling around the joint. Due to lower limb swelling, such fractures may be misdiagnosed as deep vein thrombosis (DVT). DVT can be diagnosed using Doppler ultrasonography, while femoral neck fractures can be identified through lateral radiography. Careful attention to patient history and the performance of complete and accurate imaging studies collectively play a vital role in minimizing diagnostic errors by medical staff. These comprehensive measures can help prevent complications and improve treatment outcomes.