Conservative Management of a Femoral Neck Stress Fracture in a Female Athlete. A Case Report and Review of the Literature

Femoral-neck stress fractures are relatively rare and may present as sports-related injuries. The presentation is variable, and prompt diagnosis facilitates the earliest return to pre-morbid functional activity levels. Delayed detection may precipitate femoral non-union or avascular necrosis, resulting in long-term functional deficit.We describe the clinical, diagnostic and therapeutic approach of a femoral-neck stress fracture that occurred in a 28-year-old female recreational runner. The pathophysiology and practical management issues related to this unusual injury pattern are discussed.The growing interest in amateur athletic activities should raise the index of suspicion for stress fractures of the femoral neck in healthy adults with atypical hip pain. In-creased levels of patient education and physician awareness can reduce the incidence of long-term morbidity in cases of this unusual sports-related injury. Moreover, measures to avoid stress fractures of the femoral neck should include proper nutrition, suitable training techniques, training intensity and appropriate foot wear. Close follow-up of athletes with a history of deep groin pain during exercise might, together with swift examination by magnetic resonance imaging or radionuclide scanning, be essential in preventing displacement of fractures and possible avascular necrosis of the femoral head as a consequence.