Young man with sudden severe hip pain secondary to femoral neck stress fracture

Abstract

Femoral neck stress fractures have been described in military recruits and athletes. Early recognition and aggressive treatment are important, as femoral neck stress fractures have a high potential for complications and even uncomplicated fractures require an extensive course of rehabilitation. Tension-side (superolateral) stress fractures of the femoral neck are at high risk for complications such as displacement, non-union and avascular necrosis, and need to be treated surgically, while compression-side (inferomedial) fractures can be treated conservatively. We describe a case illustrating a typical presentation of insidious hip pain culminating in sudden onset of severe hip pain in a healthy young man. We perform a literature review of studies showing epidemiology, treatment algorithms and rehabilitation.

Femoral Neck Stress Fractures in South Korean Male Military Recruits

“… 3 , 21) One underlying physiological effect of insufficient preservice physical activity is inadequate adaptation of bones and other connective tissues to high-impact activities such as running, cutting, and jumping. 10 , 22 , 23) Arguably, FNSFs are the most devastating bone stress injury. 8) Loss of the shockabsorbing effects of the gluteus medius and minimus muscles, which are significant stabilizers of tensile forces at the superior aspect of the femoral neck, results in FNSFs when the muscles become fatigued under repetitive high stress.…”

“…It should be noted that the findings of physical examination in earlier reports were nonspecific and that the duration of symptoms or pain could not be used to differentiate FNSFs from other diagnoses. 7 , 22 , 28) …”