Hip
Femoral Neck Stress Fracture
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Femoral Neck Stress Fracture
See Also
Groin Injuries in Athletes
Stress Fracture
Pathophysiology
As with other
Stress Fracture
s, 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 Fracture
s 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]
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