Femoral neck stress fracture in a female athlete: a case report

Abstract

Objective: The purpose of this case report is to describe chiropractic rehabilitation of a master's-level athlete with proximal femoral stress fracture and provide a brief discussion of stress fracture pathology. Clinical Features: A 41-year-old female master's-level endurance athlete presented with chronic groin pain later diagnosed and confirmed by magnetic resonance imaging as a stress fracture of the femoral neck. After diagnosis, the patient was referred to a doctor of chiropractic at week 1 of the non-weight-bearing physical rehabilitation process. At that time, the patient presented with sharp and constant groin pain rated 6/10 on a numeric rating scale. Intervention and Outcome: This patient avoided weight-bearing activity for 8 weeks while cross-training and was able to return to her sport after this period. The patient was progressed through a series of non-weight-bearing strengthening exercises for the lower extremity. Myofascial release therapy was performed on the gluteal, hip flexor, and groin muscle groups to improve range of motion. Motion palpation testing the lumbar and sacroiliac joints was performed during each session, and manipulative therapy was performed when necessary. The patient was seen once a week for 8 weeks. Reevaluation was performed at week 8; at that time, the patient reported no groin pain (0/10). The patient was discharged from care and referred back to the supervising physician for clearance to return to sporting activities. One month after discharge, she reported that she was pain free and had fully returned to sport activities. Conclusion: This case report demonstrates the importance of a through clinical history, physical examination, and magnetic resonance imaging in the accurate diagnosis of a patient with chronic groin pain and that chiropractic care can contribute to rehabilitation programs for these injuries.

Femoral Neck Stress Fractures in Sport: A Current Concepts Review

“…If conservative management is chosen, then the patient should be limited weight-bearing with crutches until they are completely free of pain 5 24 45 49 . This normally takes between 6 to 8 weeks but can be up to 14 weeks 5 24 45 49 .…”

“…If conservative management is chosen, then the patient should be limited weight-bearing with crutches until they are completely free of pain 5 24 45 49 . This normally takes between 6 to 8 weeks but can be up to 14 weeks 5 24 45 49 . During this time, weight-bearing through the injured side can be gradually increased from non-weight-bearing to toe-touch weight bearing to partial weight-bearing, as pain allows 5 24 45 49 .…”

Correlation Between Reduction Quality of Femoral Neck Fracture and Femoral Head Necrosis Based on Biomechanics

“…Garden classification is the most common method for assessing the quality of fracture reduction, which is based on X‐rays. However, the fact that X‐rays are 2D images generated from a projected 3D image results in image overlap, occlusions, and distortions, which limit the evaluation of fracture displacement and rotation. A 3D reconstruction technique based on a CT workstation has also been proposed for the evaluation of postoperative reduction quality of femoral fractures.…”

Compression type stress fracture of femoral neck with equivocal X-ray features diagnosed on 99mTc-MDP SPECT/CT in a case of trivial hip pain

“…However, in the majority of cases, there may not be obvious abnormality on plain radiograph. [ 3 4 ] On histology, in a stress insufficiency fracture, repeated stress leads to the early reparative osteoblastic response which outpaces osteoclastic activity. With continued physical activity, trabecular microfractures occur.…”