Department of Orthopedics, The Armed Forces Capital Hospital, Seongnam, Korea.
Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Clin Orthop Surg. 2021 Mar;13(1):24-29. doi: 10.4055/cios20074. Epub 2020 Dec 11.
Femoral neck stress fractures (FNSFs) are rare but potentially disabling injuries if the diagnosis is missed or delayed and proper treatment is not provided. The aim of this study was to investigate and describe the characteristics and clinical course of FNSFs in South Korean male military recruits.
Between May 2015 and October 2019, 16 fractures in 12 young male military recruits were reviewed. The characteristics of the fractures were ascertained by detailed analysis of the history and clinical course, as well as radiographs, bone scintigrams, and magnetic resonance images.
The median duration between endurance training and the development of hip pain was 5 weeks, while the median duration of pain before the patient sought medical attention was 3 weeks. Four patients (33.3%) exhibited bilateral fractures, and concomitant lesions involving the proximal tibia were found in 3 patients (25%). Fourteen of the 16 fractures (87.5%) were compression-type fractures, and surgery was performed for 7 hips. Complete union without malunion or osteonecrosis was achieved in all cases, and all cadets returned to their full activity levels in an average of 10 weeks.
We observed excellent prognosis of FNSFs. Our report highlights the importance of early reporting, detection, and treatment regarding the challenging management of FNSFs. When a military recruit reports hip pain, a FNSF should be considered; furthermore, the bilaterality of the fracture and the presence of concomitant lesions should also be investigated.
股骨颈应力性骨折（FNSF）较为罕见，但如果漏诊或延误诊断且未给予恰当治疗，可能导致严重后果。本研究旨在探讨和描述韩国男性新兵 FNSF 的特征和临床病程。
2015 年 5 月至 2019 年 10 月，共回顾分析了 12 名年轻男性新兵中的 16 例 FNSF。通过详细分析病史和临床病程、X 线片、骨闪烁扫描和磁共振成像来确定骨折特征。
从耐力训练到出现髋部疼痛的中位时间为 5 周，而从出现疼痛到就诊的中位时间为 3 周。4 名患者（33.3%）存在双侧骨折，3 名患者（25%）存在同时累及胫骨近端的伴随损伤。16 例骨折中有 14 例（87.5%）为压缩型骨折，7 髋接受了手术治疗。所有病例均达到完全愈合，无畸形愈合或骨坏死，所有学员平均在 10 周内恢复到全部活动水平。
我们观察到 FNSF 的预后良好。本报告强调了早期报告、发现和治疗的重要性，以应对 FNSF 治疗的挑战。当新兵报告髋部疼痛时，应考虑 FNSF 的可能性；此外，还应调查骨折的双侧性和伴随损伤的存在。
