Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2022; 10(13): 4280-4287
Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4280
Multiple stress fractures of unilateral femur: A case report
Mao-Ting Tang, Chun-Feng Liu, Jin-Lian Liu, Saijilafu, Zhen Wang
Mao-Ting Tang, Chun-Feng Liu, Jin-Lian Liu, Zhen Wang, Department of Orthopaedics, Suzhou Kowloon Hospital Shanghai Jiao Tong University School of Medicine, Suzhou 215028, Jiangsu Province, China
Saijilafu, Orthopaedic Institute, Medical College, Soochow University, Suzhou 215007, Jiangsu Province, China
Author contributions: Tang MT reviewed the literature and contributed to drafting the manuscript; Liu CF reviewed the literature and followed up with the patient; Liu JL reviewed the literature and performed the operation; Saijilafu made important intellectual contributions to the revision of the manuscript for publication; Wang Z reviewed the literature and helped revise the manuscript; all authors issued final approval for the version to be submitted.
Supported by Suzhou Gusu Health Talent Program Training Program, No. GSWS2020121.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhen Wang, PhD, Doctor, Department of Orthopaedics, Suzhou Kowloon Hospital Shanghai Jiao Tong University School of Medicine, No. 118 Wansheng Street, Industrial Park, Suzhou 215028, Jiangsu Province, China. qiushui21@163.com
Received: December 10, 2021
Peer-review started: December 10, 2021
First decision: January 26, 2022
Revised: February 7, 2022
Accepted: March 16, 2022
Article in press: March 16, 2022
Published online: May 6, 2022
Processing time: 140 Days and 17 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

Muscle fatigue and hip varus deformity provide an anatomical basis for the occurrence of femoral neck stress fractures.

Keywords: Femoral neck fracture; Femoral fracture; Stress fracture; Fatigue fracture; Hip pain; Case report

Core Tip: Stress fractures of the femoral neck are not common in clinical practice. Additionally, simultaneous stress fractures of the femoral neck and proximal femur of the unilateral femur are even more rare and have not been reported in the literature. We found that varus deformity of the hip provides an anatomical basis for the occurrence of stress fractures of the proximal femur. Early diagnosis is very important for the treatment of femoral neck stress fractures. The classification of femoral neck stress fractures guides the treatment options.