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Femoral neck stress fractures.
1Department of Surgery, Medical College of Georgia, Augusta.
Sports Medicine (Auckland, N.Z.)
|March 1, 1990
Summary
Femoral neck stress fractures, though uncommon in athletes, require prompt diagnosis. Early recognition and supervised treatment are crucial to prevent displacement and long-term complications like avascular necrosis.
Area of Science:
- Orthopedics
- Sports Medicine
- Radiology
Background:
- Femoral neck stress fractures are unusual but not rare athletic injuries, accounting for 5% of all stress fractures.
- Early recognition is vital due to often delayed objective findings and serious potential complications.
- Etiology involves repetitive force exceeding bone's response capacity, potentially exacerbated by muscle fatigue or motion limitations.
Purpose of the Study:
- To highlight the importance of early recognition and diagnosis of femoral neck stress fractures.
- To outline diagnostic methods and radiographic progression of these injuries.
- To present a classification system and corresponding treatment strategies.
Main Methods:
- Review of clinical presentation including groin pain.
- Diagnostic imaging including plain radiography and bone scintigraphy.
- Classification based on radiographic changes: compression side, tension side, and displaced fractures.
Main Results:
- Radiographic findings progress from normal to sclerosis, cortical disruption, and displacement.
- Bone scintigraphy can detect changes 2+ weeks earlier than plain films.
- A 3-category classification system guides treatment.
Conclusions:
- Prompt diagnosis and supervised treatment are key to preventing displacement.
- Displacement is associated with prolonged disability, nonunion, and avascular necrosis.
- Treatment varies from rest to surgical stabilization based on fracture type.