Skip to main content

Surgical Technique: Surgical Fixation of Nondisplaced Femoral Neck Stress Fracture

  • Reference work entry
  • First Online:
Hip Arthroscopy and Hip Joint Preservation Surgery

Abstract

Femoral neck stress fracture (FNSF) is an uncommon pathology, usually related to athletic participation and military activity. They represent a type of fatigue fracture, which occur secondary to repeated loads on a normal bone. While incomplete compression-side FNSF are stable, and can be treated nonoperatively, tension-side or complete fractures are unstable and are at risk of displacement. Thus, prompt diagnosis is critical and surgical management with internal fixation is often recommended.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 699.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 799.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Robertson GA, Wood AM. Femoral neck stress fractures in sport: a current concepts review. Sports Med Int Open. 2017;1(2):E58–68.

    Article  Google Scholar 

  2. Moerenhout K, Gkagkalis G, Laflamme GY, Rouleau DM, Leduc S, Benoit B. Total hip arthroplasty for bilateral femoral neck stress fracture: a case report and review of the literature. Adv Orthop. 2019;2019:2720736.

    Article  Google Scholar 

  3. DeFranco MJ, Recht M, Schils J, Parker RD. Stress fractures of the femur in athletes. Clin Sports Med. 2006;25(1):89–103, ix.

    Article  Google Scholar 

  4. Shin AY, Gillingham BL. Fatigue fractures of the femoral neck in athletes. J Am Acad Orthop Surg. 1997;5(6):293–302.

    Article  CAS  Google Scholar 

  5. Ramey LN, McInnis KC, Palmer WE. Femoral neck stress fracture: can MRI grade help predict return-to-running time? Am J Sports Med. 2016;44(8):2122–9.

    Article  Google Scholar 

  6. Muldoon MP, Padgett DE, Sweet DE, Deuster PA, Mack GR. Femoral neck stress fractures and metabolic bone disease. 2001. J Orthop Trauma. 2003;17(8 Suppl):S12–6.

    Google Scholar 

  7. Nattiv A, Kennedy G, Barrack MT, Abdelkerim A, Goolsby MA, Arends JC, et al. Correlation of MRI grading of bone stress injuries with clinical risk factors and return to play: a 5-year prospective study in collegiate track and field athletes. Am J Sports Med. 2013;41(8):1930–41.

    Article  Google Scholar 

  8. Behrens SB, Deren ME, Matson A, Fadale PD, Monchik KO. Stress fractures of the pelvis and legs in athletes: a review. Sports Health. 2013;5(2):165–74.

    Article  Google Scholar 

  9. Carpintero P, Leon F, Zafra M, Serrano-Trenas JA, Román M. Stress fractures of the femoral neck and coxa vara. Arch Orthop Trauma Surg. 2003;123(6):273–7.

    Article  CAS  Google Scholar 

  10. Pouilles JM, Bernard J, Tremollières F, Louvet JP, Ribot C. Femoral bone density in young male adults with stress fractures. Bone. 1989;10(2):105–8.

    Article  CAS  Google Scholar 

  11. Pihlajamäki HK, Ruohola JP, Weckström M, Kiuru MJ, Visuri TI. Long-term outcome of undisplaced fatigue fractures of the femoral neck in young male adults. J Bone Joint Surg Br. 2006;88(12):1574–9.

    Article  Google Scholar 

  12. Weistroffer JK, Muldoon MP, Duncan DD, Fletcher EH, Padgett DE. Femoral neck stress fractures: outcome analysis at minimum five-year follow-up. J Orthop Trauma. 2003;17(5):334–7.

    Article  Google Scholar 

  13. Neubauer T, Brand J, Lidder S, Krawany M. Stress fractures of the femoral neck in runners: a review. Res Sports Med. 2016;24(3):185–99.

    Article  Google Scholar 

  14. Scott MP, Finnoff JT, Davis BA. Femoral neck stress fracture presenting as gluteal pain in a marathon runner: case report. Arch Phys Med Rehabil. 1999;80(2):236–8.

    Article  CAS  Google Scholar 

  15. Fullerton LR, Snowdy HA. Femoral neck stress fractures. Am J Sports Med. 1988;16(4):365–77.

    Article  Google Scholar 

  16. Shin AY, Morin WD, Gorman JD, Jones SB, Lapinsky AS. The superiority of magnetic resonance imaging in differentiating the cause of hip pain in endurance athletes. Am J Sports Med. 1996;24(2):168–76.

    Article  CAS  Google Scholar 

  17. Niva MH, Kiuru MJ, Haataja R, Pihlajamäki HK. Fatigue injuries of the femur. J Bone Joint Surg Br. 2005;87(10):1385–90.

    Article  CAS  Google Scholar 

  18. Devas MB. Stress fractures of the femoral neck. J Bone Joint Surg Br. 1965;47(4):728–38.

    Article  CAS  Google Scholar 

  19. Provencher MT, Baldwin AJ, Gorman JD, Gould MT, Shin AY. Atypical tensile-sided femoral neck stress fractures: the value of magnetic resonance imaging. Am J Sports Med. 2004;32(6):1528–34.

    Article  Google Scholar 

  20. Arendt EA, Griffiths HJ. The use of MR imaging in the assessment and clinical management of stress reactions of bone in high-performance athletes. Clin Sports Med. 1997;16(2):291–306.

    Article  CAS  Google Scholar 

  21. Ragab Y, Emad Y, Abou-Zeid A. Bone marrow edema syndromes of the hip: MRI features in different hip disorders. Clin Rheumatol. 2008;27(4):475–82.

    Article  Google Scholar 

  22. Siavashi B, Aalirezaei A, Moosavi M, Golbakhsh MR, Savadkoohi D, Zehtab MJ. A comparative study between multiple cannulated screws and dynamic hip screw for fixation of femoral neck fracture in adults. Int Orthop. 2015;39(10):2069–71.

    Article  Google Scholar 

  23. Kanwat H, Mittal S, Trikha V, Malhotra R. Unusual bilateral neck of femur stress fracture in a healthy, non-athletic individual – a case report and literature review. J Orthop Case Rep. 2019;9(2):90–3.

    PubMed  PubMed Central  Google Scholar 

  24. Hernigou J, Koulischer S, Maes R. Bilateral simultaneous femoral neck stress fracture despite clinical recovery from anorexia nervosa: a case report. JBJS Case Connect. 2017;7(1):e12.

    Article  Google Scholar 

  25. Biz C, Berizzi A, Crimì A, Marcato C, Trovarelli G, Ruggieri P. Management and treatment of femoral neck stress fractures in recreational runners: a report of four cases and review of the literature. Acta Biomed. 2017;88(4S):96–106.

    PubMed  PubMed Central  Google Scholar 

  26. Robertson GA, Wood AM. Lower limb stress fractures in sport: optimising their management and outcome. World J Orthop. 2017;8(3):242–55.

    Article  Google Scholar 

  27. Vitalkar S, Manglunia AS, Kulkarni A, Puranik AD. Compression type stress fracture of femoral neck with equivocal X-ray features diagnosed on (99m)Tc-MDP SPECT/CT in a case of trivial hip pain. Indian J Nucl Med. 2016;31(3):225–8.

    Article  Google Scholar 

  28. O’Brien J, Taunton J, Larsen J, Forster BB. 31-year-old female runner with 5-week history of hip pain. Br J Sports Med. 2011;45(2):136–9.

    Article  Google Scholar 

  29. Takkar P, Prabhakar R. Stress fractures in military recruits: a prospective study for evaluation of incidence, patterns of injury and invalidments out of service. Med J Armed Forces India. 2019;75(3):330–4.

    Article  Google Scholar 

  30. Kusnezov NA, Eisenstein ED, Dunn JC, Waterman BR. Functional outcomes following surgical management of femoral neck stress fractures. Orthopedics. 2017;40(3):e395–e9.

    Article  Google Scholar 

  31. Chalupa RL, Rivera JC, Tennent DJ, Johnson AE. Correlation between femoral neck shaft angle and surgical management in trainees with femoral neck stress fractures. US Army Med Dep J 2016:1–5.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Williams, J.C., Bessa, F.S., Terhune, E.B. (2022). Surgical Technique: Surgical Fixation of Nondisplaced Femoral Neck Stress Fracture. In: Nho, S.J., Bedi, A., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-43240-9_180

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-43240-9_180

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-43239-3

  • Online ISBN: 978-3-030-43240-9

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics