Displaced fractures of the proximal femur are characterized by which deformity?

• A. A flexed hip joint and inward thigh rotation
• B. Shortening and external rotation
• C. Lengthening and internal rotation
• D. Extension and external rotation

Answer: (B)

Displaced fractures of the proximal femur typically produce a leg that is shortened and externally rotated. The fracture disrupts alignment around the hip, causing the proximal segment to tilt and the distal fragment to be pulled outward by the external rotator muscles (piriformis, obturators, gemelli, quadratus femoris). This combination makes the limb appear shorter and rotated away from the midline. The other patterns described—flexed hip with inward rotation (seen with posterior hip dislocation), lengthening with internal rotation, or extension with external rotation—do not match the common deformity produced by a proximal femur fracture. Therefore, shortening with external rotation best describes this injury.