Katsougrakis Ilias, Apostolopoulos Alexandros P, Tross Samantha Z
Trauma and Orthopaedic Department, Ealing Hospital NHS Trust, London North West Healthcare, UK.
J Long Term Eff Med Implants. 2016;26(1):7-12. doi: 10.1615/JLongTermEffMedImplants.2016011991.
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.
股骨颈应力性骨折相对少见，可能表现为与运动相关的损伤。其临床表现多样，及时诊断有助于尽早恢复到病前的功能活动水平。延迟发现可能导致股骨不愈合或缺血性坏死，从而造成长期功能缺陷。
我们描述了一名28岁女性业余跑步者发生的股骨颈应力性骨折的临床、诊断和治疗方法。讨论了与这种不寻常损伤模式相关的病理生理学和实际管理问题。
对业余体育活动的兴趣日益增加，应提高对有非典型髋部疼痛的健康成年人股骨颈应力性骨折的怀疑指数。加强患者教育和医生意识可以降低这种不寻常的与运动相关损伤病例的长期发病率。此外，避免股骨颈应力性骨折的措施应包括适当的营养、合适的训练技术、训练强度和合适的鞋类。对有运动时腹股沟深部疼痛病史的运动员进行密切随访，结合磁共振成像或放射性核素扫描的快速检查，对于预防骨折移位和可能由此导致的股骨头缺血性坏死可能至关重要。
