Long-term outcome of undisplaced fatigue fractures of the femoral neck in young male adults

Abstract

The incidence and long-term outcome of undisplaced fatigue fractures of the femoral neck treated conservatively were examined in Finnish military conscripts between 1970 and 1990. From 106 cases identified, 66 patients with 70 fractures were followed for a mean of 18.3 years (11 to 32). The original medical records and radiographs were studied and physical and radiological follow-up data analysed for evidence of risk factors for this injury. The development of avascular necrosis and osteoarthritis was determined from the follow-up radiographs and MR scans. The impact of new military instructions on the management of hip-related pain was assessed following their introduction in 1986. The preventive regimen (1986) improved awareness and increased the detected incidence from 13.2 per 100,000 service-years (1970 to 1986) to 53.2 per 100,000 (1987 to 1990). No patient developed displacement of the fracture or avascular necrosis of the femoral head, or suffered from adverse complications. No differences were found in MRI-measured hip joint spaces at final follow-up. The mean Harris Hip Score was 97 (70 to 100) and the Visual Analogue Scale 5.85 mm (0 to 44). Non-operative treatment, including avoidance of or reduced weight-bearing, gave favourable short- and long-term outcomes. Undisplaced fatigue fractures of the femoral neck neither predispose to avascular necrosis nor the subsequent development of osteoarthritis of the hip.

Acetabular Retroversion in Military Recruits with Femoral Neck Stress Fractures

“…Symptoms often develop after initiating or increasing the intensity of a conditioning program [6]. Although nondisplaced FNSFs almost uniformly heal with appropriate treatment, there have outcomes do not always correlate with radiographic union [19,26]. Some patients have long-term hip pain and decreased functional scores despite radiographic resolution [26].…”

Femoral Neck Stress Fractures

“…2,3 Endurance athletes may be particularly at risk, especially females, military recruits, runners, and triathletes. 4,5 Microtrauma to bone occurs with physical activity that induces strain. 6 In normal bone, the microdamage is repaired and osseous homeostasis maintained.…”

Femoral neck fatigue fracture on morbid obesity: A case report

“…The fracture does not appear suddenly. It occurs from repeated traumas, none of which is sufficient to cause a sudden break, but which, when added to gether, overwhelm the osteoblasts that remodel the bone [4] . The genesis of the femoral neck fatigue fracture is controversial [5] .…”