Stress fractures of the femur in runners.

Early diagnosis, followed by conservative management, permitted five of six long-distance runners to return to running after they had suffered stress fractures of the femur. The sixth patient developed a displaced fracture of the femoral neck which was openly reduced and internally fixated at surgery: this athlete returned to marathoning one year later. In the series there were two fractures of the femoral neck and four of the proximal medical shaft of the femur. Although early diagnosis depends upon a complete history, physical examination and x-ray film results, bone scanning is a further aid when x-ray films still do not confirm the presumptive diagnosis.