What is the typical position of the foot in a patient with a hip fracture?

In a patient with a hip fracture, the typical position of the foot is externally rotated. This external rotation occurs due to the mechanism of the injury and the muscle imbalances that arise from the fracture. Muscles such as the iliopsoas, which are responsible for flexion and external rotation of the hip, may pull the leg externally, creating this characteristic positioning.

Additionally, the anatomical structure of the hip joint means that when the femur is fractured, especially in cases of intertrochanteric or femoral neck fractures, the thigh tends to fall into this position due to gravity and the fact that surrounding muscles are no longer properly anchored by the intact bone structure. This results in the foot pointing outward, which is a classic clinical finding in hip fractures.

In contrast, a neutral position would not typically present with the muscular and joint derangement seen in fractures, and adducted positioning is more associated with certain injury patterns or hip dislocations, which is not typical in simple hip fractures. Internally rotated positioning might be seen in other conditions or injuries but does not align with the common presentation of a hip fracture.