Displaced stress fracture of the femoral neck in young active adults

Abstract

Stress fractures of the femoral neck in healthy individuals are rare and most prevalent among long-distance runners and military recruits. Women seem to be at higher risk of developing stress fractures because of possible eating disorders and, thereby, following amenorrhoea and osteoporosis. The majority of fractures of the femoral neck are undisplaced. However, they might progress into displaced fractures with avascular necrosis of the femoral head and following development of osteoarthritis as a probable consequence even when treated properly. Early diagnosis with MRI or radionuclide scanning in patients with a history of pain in the groin region during training might be crucial in detecting the fractures at early stages; thereby preventing possible complications following surgical treatment of displaced fractures. The authors present a report of two young adults who developed displaced fractures of the femoral neck and were treated with closed reduction and internal fixation.

Figure 1

Radiographs of displaced tension-type stress fracture of the medial femoral neck treated with closed reduction and internal fixation with three cannulated screws. (A) Preoperative radiographs, (B) postoperative radiographs, (C) 12 months’ follow-up.

Figure 2

Radiographs of displaced tension-type stress fracture of the lateral femoral neck treated with closed reduction and internal fixation with dynamic hip screw and plate. (A) Preoperative radiographs, (B) postoperative radiographs, (C) 12 months’ follow-up.