Femoral Neck Stress Fracture and Femoroacetabular Impingement

Taylor-Haas, Jeffery A.; Paterno, Mark V.; Shaffer, Michael D.

doi:10.2519/jospt.2011.0423

Cited by 11 publications

(14 citation statements)

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“…11 Based on this, the authors concluded that impingement should be addressed at the same time as the fracture fixation. In this context, a correlation between FAI and femoral neck stress fractures has also been described, 12 where the Pincer morphology was found to be associated with 78% of femoral neck fracture. 13 It is also known that the femoroacetabular impingement is associated with posterior hip dislocation.…”

Section: Introductionmentioning

confidence: 91%

Epidemiology of proximal femoral fractures

Bäcker

Maniglio

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Introduction: With increasing age, the incidence of proximal femoral fractures increases steadily.Although the different treatments are investigated frequently, little is known about the seasonal variation and predisposing factors. The purpose of this study is to investigate the epidemiology, the impact of femoroacetabular impingement, as well as the presence of osteoarthritis. Methods: We performed a retrospective review of all patients with pertrochanteric, lateral and medial femoral neck fractures between 2012 and 2019. Inclusion criteria consisted of patients older than 18 years old who presented with isolated proximal femoral fractures without any congenital or hereditary deformity. For analysis, we assessed the demographics, season at time of accident, Kellgren-Lawrence score and corner edge (CE) angle. Results: In total, 187 patients were identified at a mean age of 75.1 ± 12.9 years old. Females consisted of 54.5% of this cohort. Most commonly, patients tend to present in winter with pertrochanteric fractures whereas no seasonal variation was found for medial femoral neck fractures. Significant correlations between season and age (regression coefficient À0.050 ± 0.021; p < 0.05) were identified. In medial neck fractures, the Gardner score was lower and Kellgren-Lawrence score higher for both female than males (p < 0.05). Patients with lateral neck fractures were significantly younger at 68.6 ± 12.5 years old (p < 0.05). In pertrochanteric fractures, the Kellgren-Lawrence score was significantly higher at 2.1 ± 0.8 (p < 0.05) with higher CE angle at 43.0 ± 7.6 (p ¼ 0.14). Conclusion: With increasing incidences of proximal femoral fractures, it is essential to recognize potential risk factors. This allows for development of new guidelines and algorithm that can aid in diagnosis, prevention, and education for patients.

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Section: Introductionmentioning

confidence: 91%

Epidemiology of proximal femoral fractures

Bäcker

Maniglio

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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“…Further factors found to pre-dispose individuals to develop FNSFs include a sudden increase in training intensity, coxa vara, coxa profunda and acetabular retroversion, as seen in pincer-type femoral acetabular impingement (FAI) 14 25 39 . However, an established link between FNSF and FAI has yet to be confirmed 25 34 59 .…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

“…The return-to-sport data in the current literature for athletes with FNSFs is limited, with only 2 studies and one systematic review providing comprehensive information on return to sport for these injuries ( Table 2 ) 30 49 . The remaining literature is restricted to case reports and case series ( Table 3 ) 5 6 7 11 13 15 16 18 20 26 27 28 32 33 36 38 41 43 46 51 55 57 58 59 61 62 63 .…”

Section: Return To Sport and Injury Preventionmentioning

confidence: 99%

“…The causative sports were long-distance running in 18 cases, marathon running in 10, jogging in 2, walking in one and skiing in one 5 6 7 11 13 15 16 18 20 26 27 28 32 33 36 38 41 43 46 51 55 57 58 59 61 62 63 . There were 12 conservatively managed compression fractures, 15 surgically managed displaced fractures and 5 surgically managed undisplaced fractures 5 6 7 11 13 15 16 18 20 26 27 28 32 33 36 38 41 43 46 51 55 57 58 59 61 62 63 . For the conservatively managed compression FNSFs, the combined return rate was 9/11; the return times ranged from 3 to 18 months 5 7 11 28 …”

Section: Return To Sport and Injury Preventionmentioning

confidence: 99%

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Femoral Neck Stress Fractures in Sport: A Current Concepts Review

Robertson

Wood

2017

Sports Med Int Open

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Femoral neck stress fractures (FNSFs) account for 3% of all sport-related stress fractures. The commonest causative sports are marathon and long-distance running.The main types of FNSF are compression-sided, tension-sided and displaced. The most common reported symptom is exercise-related groin pain. Radiographs form the first line of investigation, with MRI the second-line investigation.The management of FNSFs is guided by the location and displacement of the fracture. Delay in diagnosis is common and increases the likelihood of fracture displacement. Sporting outcomes are considerably worse for displaced fractures. Education programmes and treatment protocols can reduce the rates of displaced FNSFs.This article aims to provide a current concepts review on the topic of FNSFs in sport, assess the current evidence on the epidemiology and pathophysiology of these injuries, detail the current recommendations for their imaging and management, and review the recorded sporting outcomes for FNSFs in the existing literature.From this study, we conclude that although FNSFs are a rare injury, they should be considered in all athletes presenting with exercise-related hip pain, because delay in diagnosis and subsequent fracture displacement can significantly impair future return to sport. However, when detected early, FNSFs show promising results in terms of return-to-sport rates and times.

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“…If osteoarthritis was previously developed by FAI before stress fracture, hip symptoms can persist after fracture healing. When the stress fracture is associated with FAI, the combined cam or pincer lesion can be corrected with internal fixation by debridement of protruded head-neck junction and superior labrum [10]. We performed total hip arthroplasty because of combined hip osteoarthritis and the avoidance of nonunion by repeated abuttment.…”

Section: Discussionmentioning

confidence: 99%

Stress Fracture of the Femoral Neck in Patient With Excessive Acetabular Anteversion and Coxa Profunda: A Case Report

Kim

2013

J Med Cases

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The underlying pathomechanisms of stress fracture of the femoral neck remains unclear. Repeated or vigorous exercise or insufficient bone strength was known to be a causing factor. Recently, femoroacetabular impingement (FAI) by abnormal contact between acetabular rim and femoral head-neck is possibly known to cause a stress fracture of femoral neck. We experienced a rare case of stress fracture of femoral neck in 59-year-old patient with increased acetabular anteversion and coxa profunda. Focal or general over-coverage of femoral head by acetabulum which might evoke repeated collision between acetabulum and femoral neck caused stress fracture of femoral neck.

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Femoral Neck Stress Fracture and Femoroacetabular Impingement

Cited by 11 publications

References 0 publications

Epidemiology of proximal femoral fractures

Epidemiology of proximal femoral fractures

Femoral Neck Stress Fractures in Sport: A Current Concepts Review

Stress Fracture of the Femoral Neck in Patient With Excessive Acetabular Anteversion and Coxa Profunda: A Case Report

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