A displaced stress fracture of the femoral neck in an adolescent female distance runner with female athlete triad: A case report

Abstract

This report presents a case of a displaced stress fracture of the femoral neck in an adolescent female distance runner with amenorrhea. Both reduction and internal fixation were performed early after the injury. At 24 months postoperatively, magnetic resonance imaging and bone scintigraphy showed no positive signs of femoral head necrosis and bone union was confirmed on plain X-ray. A medical examination for the presence of the signs of the female athlete triad by checking weight, calorie intake and menstrual cycles is most important to prevent such stress fractures. Athletes as well as their coaches or parents therefore need to understand female athlete triad.

Figure 1

An anteroposterior X-ray of the left hip showing the femoral neck fracture. The Devas classification showed that the fracture was a displaced type fracture.

Figure 2

Postoperative X-ray of the left hip. The fracture was reduced, and internal fixation was done with the Hansson Pin System^® (Stryker).

Figure 3

Follow-up MRI 6 months after surgery. T1-weighted images demonstrate an area of low signal intensity at the fracture site, but there is no low intensity band in the femoral head.

Figure 4

Follow-up bone scintigraphy 6 months after surgery. Fracture site and the femoral head are positive, but there is no 'cold-in-hot' appearance in the femoral head.

Figure 5

Anteroposterior X-ray of the left hip 2 years postoperatively. Bone union is evident.