Femoral neck stress fracture in habitual exercise patient: A case report with literature reviews

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND 2020 Background: Femoral neck stress fracture (FNSF) is considered rare, and, as a consequence, is easily misdiagnosed due to a lack of awareness. The initial presentation can be subtle, but serious sequelae, including avascular necrosis of the femoral head or non-union could occur without proper management. Case Report: A left FNSF in a regularly exercising postmenopausal woman treated by in situ fixation with multiple cannulated screws is presented. Dual energy X-ray absorptiometry (DXA) scan revealed osteopenic bone marrow density (BMD) T-score. Subcutaneous denosumab injection was prescribed immediately following the operation according to World Health Organization (WHO) recommendation. Successful radiographic union was observed after three months without complications, and the patient was able to return to sports activities after six months. Conclusion: An early and accurate diagnosis of FNSF is essential in returning to sport and preventing undesirable harmful consequences.