Subtrochanteric stress fractures in runners

Area of Science:

• Orthopedics
• Sports Medicine
• Radiology

Background:

• Subtrochanteric femur stress fractures are uncommon in athletes.
• College track athletes may face unique training stressors.
• Early diagnosis of stress injuries is crucial for preventing complications.

Purpose of the Study:

• To report a cluster of subtrochanteric femur stress fractures in college track athletes.
• To investigate potential causes for the observed high incidence.
• To highlight the diagnostic utility of bone scanning in challenging cases.

Main Methods:

• Case series of seven college track team members.
• Diagnosis via X-ray films and bone imaging (bone scan).
• Review of suspected causative factors, including running surfaces and bounding exercises.

Main Results:

• Seven cases of subtrochanteric femur stress fractures identified.
• One case initially diagnosed as stress reaction due to negative X-rays.
• Suspected contributing factors: altered running surfaces and bounding exercises.
• Bone scanning demonstrated value in diagnosing cases with initially negative X-rays.

Conclusions:

• A change in running surfaces and bounding exercises may contribute to subtrochanteric femur stress fractures in track athletes.
• Bone scanning is a valuable tool for diagnosing stress fractures, especially after conservative treatment failure or inconclusive initial imaging.
• Recognizing the stress reaction-fracture continuum is important for timely and accurate diagnosis and management.