Biz Carlo, Berizzi Antonio, Crimì Alberto, Marcato Chiara, Trovarelli Giulia, Ruggieri Pietro
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Acta Biomed. 2017 Oct 18;88(4S):96-106. doi: 10.23750/abm.v88i4-S.6800.
Femoral neck stress fractures (FNSFs) in healthy young subjects are uncommon and most prevalent among long-distance runners and military recruits. Women seem to be at higher risk of developing stress fractures because of possible eating disorders followed by amenorrhea and osteoporosis. This case report describes four young and middle-aged, active female recreational runners who developed stress fractures of the femoral neck. In three of them, with a clinical history of persistent pain in the groin region, which worsened during training, early diagnosis by MRI was considered essential in detecting the fractures. The patients were clinically, metabolically and radiographically evaluated; they were then treated and followed-up at our institution. Only one case was treated conservatively, while the others underwent surgical internal fixation using a screw-plate (DHS®). All of them returned to sport physical activity after a recovery period. Regarding the challenging management of FNSFs, our report highlights the importance of groin pain, especially in athletic females, an early diagnosis by MRI, and a proper classification of these injuries for a correct choice of treatment in order to prevent further dislocation and avoid avascular necrosis of the femoral head.
健康年轻受试者中的股骨颈应力性骨折（FNSFs）并不常见，在长跑运动员和新兵中最为普遍。女性似乎因可能出现的饮食失调继之以闭经和骨质疏松而发生应力性骨折的风险更高。本病例报告描述了四名发生股骨颈应力性骨折的中青年活跃女性业余跑步者。其中三人有腹股沟区持续疼痛的临床病史，训练时疼痛加剧，MRI早期诊断被认为对检测骨折至关重要。对患者进行了临床、代谢和影像学评估；然后在我们机构对其进行治疗和随访。仅1例采用保守治疗，其他患者则采用螺钉钢板（DHS®）进行手术内固定。所有患者在恢复期后都恢复了体育活动。关于FNSFs具有挑战性的管理，我们的报告强调了腹股沟疼痛的重要性，尤其是在运动女性中，MRI早期诊断以及对这些损伤进行正确分类以便正确选择治疗方法以防止进一步脱位并避免股骨头缺血性坏死的重要性。
