Working Diagnosis:
Left femoral neck stress fracture with mild congenital hip dysplasia and labral tear
Treatment:
Open Reduction Internal Fixation (ORIF) left femoral neck stress fracture
Case Photo #5
Outcome:
Returned to work with restrictions 11 weeks after surgery. Full return to work 18 weeks after surgery. Started biking and strength training after therapy completed. 1 year after surgery participated in Fight for Air Climb in Detroit - charity event to raise money for American Lung Association. Climbed stairs to 71st floor of Detroit Renaissance Center. 2 years after surgery returned to running. Currently running 3 miles at a time.
Author's Comments:
The Femoral neck is associated with large compressive and sheer forces when ambulating. Femoral neck stress fractures may be commonly seen in persons with repetitive activities including runners.
If not treated, Femoral neck stress fractures can lead to avascular necrosis, nonunion of fracture or may progress to a complete fracture. Stress fractures are often not visible on plain films.
Femoral neck stress fractures can be divided into tension sided fractures and compression sided fractures. This patient had a compression sided femoral neck stress fracture. As the fracture involved 50% of the femoral neck, surgery was recommended. The patient underwent open reduction internal fixation of the left femoral neck stress fracture with a sliding hip screw.
References:
Wildstein, M. (2015, November 18). Femoral Neck Stress and Insufficiency Fractures. Medscape. Retrieved from http://emedicine.medscape.com/article/1246691-overview
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