Femoral Neck Stress Fractures

Femoral Neck Stress Fractures

 

Two types:


 -Compressions side (inferior medial side)
 -Tension Side (superior lateral side)
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Causes:


 -Repetitive loading of the femoral neck
 -Microcosmic fractures of the femoral neck
 -Microfractures unable to heal secondary to continued repetitive loading
  -With continued loading a crack is initiated and eventually propagated
 -Common in runners or repetitive running athletics or repetitive weight bearing


Presentation:


 -Individual typically involved in repetitive weight bearing activities
 -Insidious in onset
 -Pain increases with activity or high impact activities
 -Pain decreases with eliminating activities
 -Anterior thigh/groin pain in weight bearing
 -Normal exam findings


Diagnostic:


- Usually (-) radiographs
- MRI sensitive and specific
- Bone scan good sensitivity, poor specificity


Treatment:


 Non-Operative

- Non-weight bearing
- Compression side stress fracture
- <50% femoral neck width

Operative

-       ORIF
-       Compression side stress fracture
-       >50 femoral width