[Stress fractures of the femoral neck]

Abstract

Stress fractures of the femoral neck are often mismanaged, due to their banal or misleading clinical presentation, particularly in the elderly. These fractures could be secondary to an excessive mechanical stress (so-called fatigue fractures), or to a weakened bone resistance (so-called insufficiency fractures), or both. Plain radiographs are mostly useless to an early diagnosis. For this purpose, bone scintiscan and MR Imaging have a much better sensitivity, though their specificity is not absolute. Late diagnosis leads to an increased risk of complete fracture, requiring orthopedic surgery. By contrast, incomplete early-recognized fractures usually heal within few weeks on bedrest. Stress fractures of the femoral neck should be actually considered as a "menace syndrome" of femoral neck fracture, and therefore need a quick appropriate management.