Stress fractures of the femoral neck and coxa vara

Carpintero, Pedro; Leon, F Escobedo-diaz De; Zafra, Manuel; Serrano-Trenas, JA; Román, Manuel

doi:10.1007/s00402-003-0514-z

Cited by 41 publications

(31 citation statements)

References 12 publications

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“…This could possibly explain the particular fracture orientation observed on the two patients' radiographs, and the absence of previously reported histological features (12). A differential diagnosis would be the stress fractures reported to occur in femurs with coxa vara (13); however in each case, both hips looked symmetric, the contralateral neck-shaft angles measured more than the conventional cut-off for coxa vara, and the fracture lines were smooth and near-vertical.…”

Section: @ C I C E D I Z I O N I I N T E R N a Z I O N A L Imentioning

confidence: 77%

Atraumatic intracapsular neck of femur fractures after prolonged bisphosphonate treatment: a new atypical variant?

Khan

Savaridas

Hemers

et al. 2016

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SummaryWe present 2 cases of elderly females presenting with atraumatic, near-vertical (Pauwells grade 3), intracapsular neck of femur fractures. Following diagnosis of osteoporosis on DEXA scans, they had received alendronic acid for 7 and 10 years respectively. Routine blood tests and serum estimations of calcium, vitamin-D and thyroidstimulating hormone, done at admission, were within the normal ranges. These patients were managed with a hemiarthroplasty and a dynamic hip screw (DHS) respectively, following discontinuation of bisphos phonates. We present these 2 cases in light of emerging evidence that associates long-term bisphosphonate use with atypical low energy femoral fractures. Only subtrochanteric/diaphyseal fractures have been reported to date. We present a new variant of atypical femoral neck fractures in metaphyseal bone related to prolonged bisphosphonate therapy.

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Section: @ C I C E D I Z I O N I I N T E R N a Z I O N A L Imentioning

confidence: 77%

Atraumatic intracapsular neck of femur fractures after prolonged bisphosphonate treatment: a new atypical variant?

Khan

Savaridas

Hemers

et al. 2016

ccmbm

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“…Genetic factors may play a role in the development of stress fractures in individuals subjected to heavy exercise and mechanical loading [5]. Also stress fracture of the femoral neck in active adults is known to be related with coxa vara [1]. Biomechanically, direct muscle pulling effect increases in coxa vara and leads to fatigue of opposing muscle group.…”

Section: Discussionmentioning

confidence: 99%

“…Biomechanical effect by FAI mechanism in abnormal orientation of acetabulum and deep socket may predispose to development of stress fracture of femoral neck. Carpintero et al [1] reported coxa vara, a form of cam impingement, is possibly related with stress fracture of femoral neck. There was a normal neck-shaft angle (128 in degree) and no abnormal head-neck offset in our case.…”

Section: Discussionmentioning

confidence: 99%

“…Repetitive vigorous activity, abnormal quality of bone or morphologic abnormalities involving proximal femur such as coxa vara are known to be related with the development of femoral neck stress fracture [1][2][3]. Femoroacetabular impingement is a pathologic condition in which subtle structural abnormalities of proximal femur or acetabulum can evoke an abutement between femoral neck and acetabular edge.…”

Section: Introductionmentioning

confidence: 99%

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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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“…Because insufficiency stress fractures are associated with decreased bone mineral density, 37 they tend to be most common in the elderly, especially postmenopausal women. 56 Other predisposing factors for poor bone density include radiation treatments, 44 rheumatoid arthritis due at least in part to the associated disuse and either corticosteroid or methotrexate treatment, 39 renal failure, 52 coxa vara, 13 metabolic disorders, and Paget's disease. 16,40,59 FIGURE 1.…”

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confidence: 99%

Differential Diagnosis of a Femoral Neck/Head Stress Fracture

Gurney

Boissonnault²,

Andrews³

2006

J Orthop Sports Phys Ther

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Study Design: Resident's case problem. Background: Identifying stress fractures of the hip can be a challenging differential diagnosis. Pain presentation is not always predictable and radiographs may not show the fracture, especially during its early stages. Hip stress fractures left untreated can displace and necessitate open reduction internal fixation or total hip arthroplasty. Diagnosis: A 70-year-old woman presented to the physical therapy clinic with complaints of right hip pain. She had been evaluated by a physician and radiographs of the hip, which revealed some arthritic changes, were otherwise normal. Upon examination, the physical therapist observed an antalgic gait, a noncapsular pattern of limitation of hip motion, an empty painful end feel at the end range of motion (ROM) for hip abduction, external rotation, and flexion, and extreme tenderness to palpation over the anterior hip region. The therapist suspected a more pernicious problem than osteoarthritis and discussed his suspicion with the physician. The physician subsequently requested an MRI that revealed a femoral neck and head stress fracture that was later confirmed with a bone scan. The patient was provided with a walker for ambulation with a non-weight-bearing status for 6 weeks, after which she returned to physical therapy for progressive weight bearing and strengthening. She was discharged with a relatively pain-free hip and was ambulating with a cane. A 2-month follow-up examination revealed a pain-free hip and a return to all premorbid activities, including ambulation without an assistive device. Discussion: The presence of a normal radiograph of the hip should not be considered conclusive in ruling out a stress fracture in the hip region. The current case demonstrates how careful evaluation can reveal occult pathologies and prevent potentially catastrophic morbidity. J Orthop Sports Phys Ther 2006;36:80-88.

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Stress fractures of the femoral neck and coxa vara

Abstract: It is suggested that coxa vara predisposes to femoral neck stress-fracture.

Cited by 41 publications

References 12 publications

Atraumatic intracapsular neck of femur fractures after prolonged bisphosphonate treatment: a new atypical variant?

Atraumatic intracapsular neck of femur fractures after prolonged bisphosphonate treatment: a new atypical variant?

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

Differential Diagnosis of a Femoral Neck/Head Stress Fracture

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