Tang Mao-Ting, Liu Chun-Feng, Liu Jin-Lian, Wang Zhen
Department of Orthopaedics, Suzhou Kowloon Hospital Shanghai Jiao Tong University School of Medicine, Suzhou 215028, Jiangsu Province, China.
Orthopaedic Institute, Medical College, Soochow University, Suzhou 215007, Jiangsu Province, China.
World J Clin Cases. 2022 May 6;10(13):4280-4287. doi: 10.12998/wjcc.v10.i13.4280.
Stress fractures of the femoral neck are not common in clinical practice, and simultaneous stress fractures of the femoral neck and proximal femur of the unilateral femur are even more rare. We introduce a case of this type of fracture that was treated in our department, analyze the causes, and review similar stress fractures reported in the literature to provide references for the diagnosis and treatment of such conditions.
A 62-year-old female, with a free medical history, was admitted to the hospital mainly due to pain in the right hip and worsening pain in the right thigh. The patient had no obvious history of trauma. X-ray and computed tomography showed fracture of the femoral neck and proximal femur. The patient had undergone surgery 1 year prior to address a fracture of the left proximal femur that had occurred in a traffic accident. Our first consideration was stress fracture of the femoral neck; however, simultaneous stress fractures of the femoral neck and proximal femur of the unilateral femur were seen. The femoral neck stress fracture was a tension fracture, with obvious displacement and varus deformity of the hip. Considering that the patient was an elderly female, we performed total hip arthroplasty. Follow-up X-rays showed that the stress fracture of the proximal femur had mostly healed after 3 mo.
Muscle fatigue and hip varus deformity provide an anatomical basis for the occurrence of femoral neck stress fractures.
股骨颈应力性骨折在临床实践中并不常见，单侧股骨颈和股骨近端同时发生应力性骨折则更为罕见。我们介绍1例在我科治疗的此类骨折病例，分析其病因，并回顾文献中报道的类似应力性骨折，为这类疾病的诊断和治疗提供参考。
一名62岁女性，无既往病史，因右髋部疼痛及右大腿疼痛加重入院。患者无明显外伤史。X线和计算机断层扫描显示股骨颈和股骨近端骨折。该患者1年前因交通事故导致左股骨近端骨折接受过手术。我们首先考虑股骨颈应力性骨折；然而，发现单侧股骨颈和股骨近端同时发生应力性骨折。股骨颈应力性骨折为张力性骨折，髋部有明显移位和内翻畸形。考虑到患者为老年女性，我们实施了全髋关节置换术。术后3个月的随访X线显示股骨近端应力性骨折大多已愈合。
肌肉疲劳和髋内翻畸形为股骨颈应力性骨折的发生提供了解剖学基础。
