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Femoral Neck Stress Fracture
Aka: Femoral Neck Stress Fracture
- See Also
- Groin Injuries in Athletes
- Stress Fracture
- Pathophysiology
- As with other Stress Fractures, overuse injury more common in female athletes
- Risk Factors
- See Stress Fracture
- Similar risks to Pubic Ramus Stress Fracture (military recruits, distance runners)
- Symptoms
- Groin Pain or anterior thigh pain
- Provoked by activity (weight bearing)
- Relieved with rest
- Signs
- Antalgic Gait
- Pain on internal hip rotation
- Imaging
- Hip XRay
- XRay changes lag symptoms by 2-4 weeks
- MRI preferred over nuclear bone scan
- High Test Sensitivity (similar to bone scan)
- High Test Specificity (better than bone scan)
- Management
- Early diagnosis and management is critical to avoid a devastating complete Hip Fracture
- Risk Modification
- See Stress Fracture
- Image the opposite hip if Stress Fracture is found (bilateral Hip Stress Fractures are common)
- Inferior Femoral Neck Stress Fractures (medial, compressive or compression side)
- Period of non-weight bearing and Crutches
- Conservative management (as long as involves <50% of cortex)
- Return to Running and sport in 8-12 weeks
- Superior Femoral Neck Stress Fractures (lateral, tensile or tension side)
- Risk of complete Fracture or Hip Avascular Necrosis
- Open reduction and internal fixation recommended
- References
- Shahideh (2013) Crit Dec Emerg Med 27(9):10-18
- Morelli (2001) Am Fam Physician 64(8):1405-1414 [PubMed]