Femoral Supracondylar Stress Fracture in an Adult Marathon Runner: A Case Report

Treatment and Rehabilitation Approaches for Stress Fractures in Long-Distance Runners: A Literature Review

“…Based on our literature review, a total of 24 case reports describing long-distance runners’ femoral SFs have been identified [ 23 - 46 ]. The mean age of the patients was 33.2 ± 13.1 years with a range between 15 and 64 years.…”

“…Fourteen male [ 25 - 27 , 30 , 33 , 34 , 36 , 37 , 39 , 40 , 42 - 44 , 46 ] and 10 female [ 23 , 24 , 28 , 29 , 31 , 32 , 35 , 38 , 41 , 45 ] long-distance runners were diagnosed with a femur SF. Among the 24 identified femur SFs, 20 of them were observed in the femoral neck [ 23 - 27 , 29 - 43 ], three of them in the femoral shaft [ 28 , 44 , 45 ], and only one fracture involved the condyle [ 46 ]. The treatment strategy has been described in 18 out of 20 reported femoral neck SF cases in the literature [ 23 - 27 , 29 - 36 , 38 - 40 , 42 , 43 ].…”

“…However, most literature case reports represent femur and pelvis SFs. This is probably explained by the greater number of treatment complications as well as the longest rehabilitation period of these SFs [ 23 - 46 , 55 - 66 ]. Informative statistics and the return time to activity (RTA) for all reported SFs per anatomic site are represented in Figure 2 .…”

“…Of the 73 cases examined in this study, 35 patients were male [ 3 , 19 - 21 , 25 - 27 , 30 , 33 , 34 , 36 , 37 , 39 , 40 , 42 - 44 , 46 , 47 , 50 , 53 , 54 , 56 , 58 , 59 , 62 , 67 , 70 ] while 38 were female [ 23 , 24 , 28 , 29 , 31 , 32 , 35 , 38 , 41 , 45 , 48 , 49 , 51 , 52 , 55 , 57 - 61 , 63 - 66 , 69 ], showing a small propensity for SFs in female population. However, the literature shows a higher tendency of SFs in females compared to male long-distance runners [ 6 , 7 ].…”

“…From the cases studied above, the pelvis shows the lowest RTA time (3.5 months approximately) while the femur shows the greatest (10 months approximately). This is probably explained by the fact that the majority of pelvic SFs were treated conservatively, while most femoral neck SFs were treated by internal fixation and a dynamic hip screw [ 23 - 46 , 55 - 66 ]. In addition, delayed treatment has been correlated with prolonged return to activity time and therefore outlines the importance of an early SF diagnosis [ 71 ].…”