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Journal articles on the topic 'Femoral neck stress fractures'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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1

Joshi, Amit, B. R. KC, B. C. Shah, P. Chand, B. B. Thapa, and N. Kayastha. "Femoral Neck Stress Fractures in Military Personnel." Journal of Nepal Medical Association 48, no. 174 (April 1, 2009): 99–102. http://dx.doi.org/10.31729/jnma.176.

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Introduction: Stress fractures are common during military training but femoral neck stress fractures are uncommon and sometimes pose diagnostic and therapeutic challenges. An incomplete stress fracture with excellent prognosis, if left unprotected, can lead to displaced femoral neck fracture with almost 63% complication rate even with best of the treatment. The aim of this study was to analyze various aspects of the femoral neck stress fracture so that early diagnosis can be made to prevent devastating complications like osteonecrosis and non-union. Methods: The four year army hospital record of 16 patients with femoral neck stress fracture were studied. Their demographic profi le, type of fracture, presentation delay, on set of clinical symptoms and complication of femoral neck stress fracture were critically analyzed. Results: The mean age of the patient was 19.94 years. Total 74% of them developed fi rst symptoms of stress fracture between four to seven weeks of training. There was 3.4 weeks delay from the clinical onset of symptoms to the diagnosis of stress fracture. The type of femoral neck stress fracture were compression (31.25%), tension (18.75%) and displaced (50%). Out of eight displaced type of fractures, 5 (62.5%) had developed complications (3 osteonecrosis and 2 nonunion).Conclusions: Femoral neck stress fracture occurs in initial four to seven weeks of training. The high index of suspicion in initial period of training can help to detect and decreases significant morbidity.Key Words: displaced stress fractures, non-union, osteonecrosis, recruits

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2

Fullerton, LeRoy R. "Femoral Neck Stress Fractures." Sports Medicine 9, no. 3 (March 1990): 192–97. http://dx.doi.org/10.2165/00007256-199009030-00006.

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3

Cloutier, Dagan. "Femoral Neck Stress Fractures." JBJS Journal of Orthopaedics for Physician Assistants 2, no. 1 (2014): 24–27. http://dx.doi.org/10.2106/jbjs.jopa.15.00032.

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4

Maffulli, Nicola, Umile Giuseppe Longo, and Vincenzo Denaro. "Femoral Neck Stress Fractures." Operative Techniques in Sports Medicine 17, no. 2 (April 2009): 90–93. http://dx.doi.org/10.1053/j.otsm.2009.06.001.

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5

Harris, Joshua David, and Jaskarndip Chahal. "Femoral Neck Stress Fractures." Operative Techniques in Sports Medicine 23, no. 3 (September 2015): 241–47. http://dx.doi.org/10.1053/j.otsm.2015.07.001.

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6

Steele, Clarence E., Grant Cochran, Christopher Renninger, Bradley Deafenbaugh, and Kevin M. Kuhn. "Femoral Neck Stress Fractures." Journal of Bone and Joint Surgery 100, no. 17 (September 2018): 1496–502. http://dx.doi.org/10.2106/jbjs.17.01593.

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7

Fullerton, LeRoy R., and Harry A. Snowdy. "Femoral neck stress fractures." American Journal of Sports Medicine 16, no. 4 (July 1988): 365–77. http://dx.doi.org/10.1177/036354658801600411.

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8

Morinaga, Sei, Kenichi Ueshima, Yoshinobu Maruhashi, Noriyuki Hashimoto, Shoji Watanabe, and Takuya Nakamura. "Bilateral Stress Fractures of the Femoral Neck after Total Knee Arthroplasty: Importance of Early Diagnosis." Case Reports in Orthopedics 2020 (February 6, 2020): 1–4. http://dx.doi.org/10.1155/2020/3091693.

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Unilateral stress fracture of the femoral neck following total knee arthroplasty (TKA) is a rare complication; only 21 cases are described in English literature so far. Bilateral stress fractures of the femoral neck occurring simultaneously following a bilateral TKA have been seen in only 2 cases till now. We report a patient suffering from rheumatoid arthritis of both knees, who was treated with bilateral TKA. She developed spontaneous fractures of the femoral neck on both sides 12 months following the TKA. She was treated with bilateral total hip arthroplasty (THA). Stress fracture of the femoral neck should be suspected in patients complaining of hip pain who have undergone TKA.

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9

Sledge, John B. "Management of Femoral Neck Stress Fractures." Operative Techniques in Sports Medicine 14, no. 4 (October 2006): 265–69. http://dx.doi.org/10.1053/j.otsm.2006.10.002.

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10

Long, Margaret M., and Deborah M. Stetts. "Stress Fractures of the Femoral Neck." Orthopaedic Nursing 4, no. 3 (May 1985): 69–71. http://dx.doi.org/10.1097/00006416-198505000-00014.

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11

Egol, Kenneth A., Kenneth J. Koval, Frederick Kummer, and Victor H. Frankel. "Stress Fractures of the Femoral Neck." Clinical Orthopaedics and Related Research 348 (March 1998): 72???78. http://dx.doi.org/10.1097/00003086-199803000-00013.

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12

TOUNTAS, A. A., and J. P. WADDELL. "Stress Fractures of the Femoral Neck." Clinical Orthopaedics and Related Research &NA;, no. 210 (September 1986): 160???165. http://dx.doi.org/10.1097/00003086-198609000-00022.

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13

Fonte, Hélder, and Ricardo Rodrigues-Pinto. "Femoral neck stress fracture in a young female recruit: case report." Orthopaedic Journal of Sports Medicine 6, no. 6_suppl3 (June 1, 2018): 2325967118S0005. http://dx.doi.org/10.1177/2325967118s00051.

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Introduction Stress fractures of the femoral neck are rare, representing 5% of all stress fractures, and most prevalent among runners and military recruits. Women seem to be at higher risk. Most of these fractures are undisplaced. Early diagnosis with appropriate imaging in patients with a history of groin pain during training might be crucial in detecting the fractures at early stages. The goal of this paper is to report a case of femoral neck stress fracture in a young female recruit and to highlight the importance of early suspicion of this kind of lesions in military and athlete populations, especially in females, providing the right treatment and avoiding possible complications. Materials and Methods A 27-year-old female, who was enrolled in military recruit, reported left groin pain after a strenuous running exercise. After one week taking NSAIDs and without relief, she presented at medical facility. Left hip active and passive range of motion was painful.The patient reported history of amenorrhea that had started a few weeks after the onset of the recruit. An X-Ray was performed, and interpreted as normal, but MRI and CT scans revealed a nondisplaced compression-type femoral neck fracture with fatigue line <50% width. Results Female athlete triad was not present. The patient was advised to a six-week period of non-weightbearing, using crutches and restriction from physical activity. The follow-up imaging study revealed union of the femoral neck fracture. At three months, she started light impact activities and seven months after she had no pain and no daily-life limitations. Conclusion Stress fractures have been described extensively in the runner as well as military recruit population.They typically involve the lower extremity. Although relatively rare, unrecognized or untreated stress fractures of the femoral neck carry amuch higher morbidity rate than other stress fractures. If X-ray is inconclusive, MRI can be useful. Treatment depends on the location and the type of fracture. It is important to keep in mind when evaluating soldiers and athletes who present with activity-related pain that stress fractures are not uncommon and should be given significant consideration.

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14

Dorne, HL, and PH Lander. "Spontaneous stress fractures of the femoral neck." American Journal of Roentgenology 144, no. 2 (February 1985): 343–47. http://dx.doi.org/10.2214/ajr.144.2.343.

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15

Provencher, Matthew T., LT Andrew J. Baldwin, John D. Gorman, Mark T. Gould, and Alexander Y. Shin. "Atypical Tensile-Sided Femoral Neck Stress Fractures." American Journal of Sports Medicine 32, no. 6 (September 2004): 1528–34. http://dx.doi.org/10.1177/0363546503262195.

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16

Wentz, Laurel, Pei-Yang Liu, Jasminka Z. Ilich, and Emily M. Haymes. "Dietary and Training Predictors of Stress Fractures in Female Runners." International Journal of Sport Nutrition and Exercise Metabolism 22, no. 5 (October 2012): 374–82. http://dx.doi.org/10.1123/ijsnem.22.5.374.

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Purpose:To compare female runners with and without a history of stress fractures to determine possible predictors of such fractures.Methods:27 female runners (age 18–40 yr) who had had at least 1 stress fracture were matched to a control sample of 32 female runners without a history of stress fractures. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (iDXA). Subjects answered questionnaires on stress-fracture history, training, menstrual status, and diet.Results:No significant differences were found in menstrual characteristics, diet and dairy intake, or bone measurements. Weekly servings of milk during middle school significantly predicted BMD at the femur (p = .010), femoral neck (p = .002), Ward’s triangle (p = .014), and femoral shaft (p = .005). Number of menstrual cycles in the previous year predicted femoral-neck BMD (p = .004). Caffeine intake was negatively associated with BMD of the femur (p = .010), femoral neck (p = .003), trochanter (p = .038), and femoral shaft (p = .035). Weekly hours of training were negatively associated with total-body BMD (p = .021), total-body bone mineral content (p = .028), and lumbar-spine BMD (p = .011). Predictors for stress fractures included the number of years running, predominantly running on hard ground, irregular menstrual history, low total-body BMD, and low current dietary calcium intake when controlling for body-mass index (Nagelkerke R2 = .364).Conclusions:Servings of milk during middle-school years were positively correlated with hip BMD, although current calcium intake, low BMD, irregular menstrual history, hard training surface, and long history of training duration were the most important predictors of stress fractures.

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17

Robertson, Greg, and Alexander Wood. "Femoral Neck Stress Fractures in Sport: A Current Concepts Review." Sports Medicine International Open 01, no. 02 (February 2017): E58—E68. http://dx.doi.org/10.1055/s-0043-103946.

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AbstractFemoral neck stress fractures (FNSFs) account for 3% of all sport-related stress fractures. The commonest causative sports are marathon and long-distance running.The main types of FNSF are compression-sided, tension-sided and displaced. The most common reported symptom is exercise-related groin pain. Radiographs form the first line of investigation, with MRI the second-line investigation.The management of FNSFs is guided by the location and displacement of the fracture. Delay in diagnosis is common and increases the likelihood of fracture displacement. Sporting outcomes are considerably worse for displaced fractures. Education programmes and treatment protocols can reduce the rates of displaced FNSFs.This article aims to provide a current concepts review on the topic of FNSFs in sport, assess the current evidence on the epidemiology and pathophysiology of these injuries, detail the current recommendations for their imaging and management, and review the recorded sporting outcomes for FNSFs in the existing literature.From this study, we conclude that although FNSFs are a rare injury, they should be considered in all athletes presenting with exercise-related hip pain, because delay in diagnosis and subsequent fracture displacement can significantly impair future return to sport. However, when detected early, FNSFs show promising results in terms of return-to-sport rates and times.

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18

Napoli, Nicola, Jenny Jin, Katherine Peters, Rosanna Wustrack, Shane Burch, Aldric Chau, Jane Cauley, Kristine Ensrud, Michael Kelly, and Dennis M. Black. "Are Women with Thicker Cortices in the Femoral Shaft at Higher Risk of Subtrochanteric/Diaphyseal Fractures? The Study of Osteoporotic Fractures." Journal of Clinical Endocrinology & Metabolism 97, no. 7 (July 1, 2012): 2414–22. http://dx.doi.org/10.1210/jc.2011-3256.

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Abstract Context: Femoral shaft cortical thickening has been mentioned in reports of atypical subtrochanteric and diaphyseal (S/D) femur fractures, but it is unclear whether thickening precedes fracture or results from a preceding stress fracture and what role bisphosphonates might play in cortical thickening. Objective: Our objective was to examine the relationship of cortical thickness to S/D fracture risk as well as establish normal reference values for femoral cortical thickness in a large population-based cohort of older women. Design: Using pelvic radiographs obtained in 1986–1988, we measured femoral shaft cortical thickness 3 cm below the lesser trochanter in women in the Study of Osteoporotic Fractures. We measured this in a random sample and in those with S/D fractures and femoral neck and intertrochanteric fractures. Low-energy S/D fractures were identified from review of radiographic reports obtained between 1986 and 2010. Radiographs to evaluate atypia were not available. Analysis used case-cohort, proportional hazards models. Outcomes: Cortical thickness as a risk factor for low-energy S/D femur fractures as well as femoral neck and intertrochanteric fractures in the Study of Osteoporotic Fractures, adjusting for age and bone mineral density in proportional hazards models. Results: After age adjustment, women with thinner medial cortices were at a higher risk of S/D femur fracture, with a relative hazard of 3.94 (95% confidence interval = 1.23–12.6) in the lowest vs. highest quartile. Similar hazard ratios were seen for femoral neck and intertrochanteric fractures. Medial or total cortical thickness was more strongly related to fracture risk than lateral cortical thickness. Conclusions: In primarily bisphosphonate-naive women, we found no evidence that thick femoral cortices placed women at higher risk for low-energy S/D femur fractures; in fact, the opposite was true. Women with thin cortices were also at a higher risk for femoral neck and intertrochanteric fractures. Whether cortical thickness among bisphosphonate users plays a role in atypical S/D fractures remains to be determined.

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19

Konetsky, Michael, Joseph Miller, and Courtney Tripp. "Femoral Neck Stress Fracture." Journal of Orthopaedic & Sports Physical Therapy 43, no. 4 (April 2013): 275. http://dx.doi.org/10.2519/jospt.2013.0407.

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20

Berg, Eugene E. "Femoral Neck Stress Fracture." Orthopaedic Nursing 10, no. 6 (November 1991): 53???58. http://dx.doi.org/10.1097/00006416-199111000-00010.

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21

Ramey, Lindsay N., Kelly C. McInnis, and William E. Palmer. "Femoral Neck Stress Fracture." American Journal of Sports Medicine 44, no. 8 (July 20, 2016): 2122–29. http://dx.doi.org/10.1177/0363546516648319.

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22

Noda, Mitsuaki, Yukiko Nakamura, Kazuhiko Adachi, Yasuhiro Saegusa, and Masayasu Takahashi. "Dynamic finite element analysis of implants for femoral neck fractures simulating walking." Journal of Orthopaedic Surgery 26, no. 2 (May 1, 2018): 230949901877789. http://dx.doi.org/10.1177/2309499018777899.

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Background: To examine postoperative complications for osteosynthesizing femoral neck fractures (Pauwels III), biomechanical analysis should be conducted under dynamic conditions simulating for walking, not static conditions. Among the two main aims of this study, one is to pioneer the technique of dynamic finite element (FE) analysis, and the other is to compare stress distribution between two implants during walking. Materials and Methods: First, we performed an inverse dynamic analysis with optimization method using a musculoskeletal model to calculate the inter-segmental and muscular forces during walking. Second, three FE models were prepared: (I) intact hip joint, (II) fractures treated with two Hansson pins (HP), and (III) fractures with Dual SC Screws (DSCS) maintaining an angular stability. The direction and magnitude of the loadings varied continuously. Stress distribution during the walking was evaluated by using a dynamic explicit method. We examined the time-dependent von Mises stresses at two representative spots: medial cortex at the femoral neck fracture site and lateral pin (presumed) insertion holes. Results: In general, stress values are always changing during walking cycle. Regarding medial femoral neck cortex at the fracture line, intact model showed almost consistent value. Both HP model and DSCS model amounted the highest around 30 MPa. At lateral holes, highest values were 18.8, 104.0, and 63.1 MPa of intact, HP, and DSCS models, respectively. Conclusion: Thus, our analysis simulating the real walking will be useful in evaluating time-varying stress distribution to assess postoperative complication. Clinical Relevance: DSCS is expected to be paramount for treatment of unstable femoral neck fractures.

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23

Pesic, Goran, Jovana Jeremic, Isidora Stojic, Aleksandra Vranic, Marija Cankovic, Tamara Nikolic, Nevena Jeremic, et al. "Redox Status in Patients with Femoral Neck Fractures." Serbian Journal of Experimental and Clinical Research 17, no. 3 (September 1, 2016): 199–206. http://dx.doi.org/10.1515/sjecr-2015-0061.

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Abstract The femur transfers the body weight from the pelvic bone to the shinbone. Femur fractures are a significant cause of morbidity and mortality among the group of locomotor apparatus injuries, especially in the elderly population. Considering that oxidative stress occurs as a result of increased production of free radicals that damage cell function and cause numerous pathological conditions and diseases, the aim of this study was to investigate oxidative stress parameters in older patients with femoral neck fractures. This clinical study included 70 patients, of which 35 had femoral neck fractures (26 males and 9 females), while the other half of the patients formed the matched control group. Markers of oxidative stress (NO2−, TBARS, H2O2 and O2-) and anti-oxidative enzymes (SOD, CAT, and GSH) were measured. Results showed that the levels of O2- increased, while levels of NO2-, H2O2 and all the antioxidative enzymes decreased in patients with femoral neck fractures. These findings indicate that fractures cause oxidative stress, probably because of the reduced activity of osteoblasts and the increased activity of osteoclasts.

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Haddad, F. S., P. N. Mohanna, and N. J. Goddard. "Bilateral femoral neck stress fractures following steroid treatment." Injury 28, no. 9-10 (November 1997): 671–73. http://dx.doi.org/10.1016/s0020-1383(97)00047-8.

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25

Johansson, Christer, Ingrid Ekenman, Hans Tornkvist, and Ejnar Eriksson. "Stress fractures of the femoral neck in athletes." American Journal of Sports Medicine 18, no. 5 (September 1990): 524–28. http://dx.doi.org/10.1177/036354659001800514.

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26

Muldoon, Michael P., Douglas E. Padgett, Donald E. Sweet, Patricia A. Deuster, and Gregory R. Mack. "Femoral Neck Stress Fractures and Metabolic Bone Disease." Journal of Orthopaedic Trauma 15, no. 3 (March 2001): 181–85. http://dx.doi.org/10.1097/00005131-200103000-00006.

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27

Muldoon, Michael P., Douglas E. Padgett, Donald E. Sweet, Patricia A. Deuster, and Gregory R. Mack. "Femoral Neck Stress Fractures and Metabolic Bone Disease." Journal of Orthopaedic Trauma 17, SUPPLEMENT (September 2003): S12—S16. http://dx.doi.org/10.1097/00005131-200309001-00004.

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28

VENTO, JOHN A., JAMES D. SLAVIN, JOHN J. O??BRIEN, and RICHARD P. SPENCER. "Bilateral ???Simultaneous??? Femoral Neck Fractures Following Minimal Stress." Clinical Nuclear Medicine 11, no. 6 (June 1986): 411–12. http://dx.doi.org/10.1097/00003072-198606000-00011.

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29

Pierre, Patrick St, Lynn T. Staheli, James B. Smith, and Neil E. Green. "Femoral Neck Stress Fractures in Children and Adolescents." Journal of Pediatric Orthopaedics 15, no. 4 (July 1995): 470–73. http://dx.doi.org/10.1097/01241398-199507000-00012.

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30

Safran, Marc R., Michael Goldin, Christian Anderson, Michael Fredericson, and Kathryn J. Stevens. "The Association of Femoral Neck Stress Fractures with Femoral Acetabular Impingement." Orthopaedic Journal of Sports Medicine 1, no. 4_suppl (January 2013): 2325967113S0005. http://dx.doi.org/10.1177/2325967113s00051.

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31

Safran, Marc Raymond, Michael Goldin, Kathryn Stevens, and Michael Fredricson. "The Association of Femoral Neck Stress Fractures With Femoral Acetabular Impingement." Arthroscopy: The Journal of Arthroscopic & Related Surgery 29, no. 10 (October 2013): e64. http://dx.doi.org/10.1016/j.arthro.2013.07.052.

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32

Robertson, G. A. J., and C. H. C. Arthur. "Femoral neck stress fractures from long distance running: a case series." Journal of The Royal Naval Medical Service 104, no. 2 (2018): 101–6. http://dx.doi.org/10.1136/jrnms-104-101.

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AbstractFemoral neck stress fractures (FNSFs) comprise 3% of all sport-related fractures, and 8% of military stress fractures. They are associated with significant morbidity; if they develop subsequent avascular necrosis of the femoral head, from late detection and fracture displacement, they require a total hip replacement in a young active individual.Knowledge of the different patterns of FNSFs, their varying presentations and their different management techniques is key for sports and military health professionals involved in the care of these injuries, to ensure optimal treatment and outcome.We report four cases of FNSFs from long distance running. Three of the four athletes returned to long distance running following their injury at mean of 7 months; however, despite two athletes participating in marathon running pre-injury, none returned to marathon running post-injury.All clinicians involved with such patients should always remain vigilant for FNSFs in any patient who presents with exercise-related hip or groin pain.

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33

Leichter, I., A. Simkin, J. Y. Margulies, A. Bivas, I. Roman, D. Deutsch, and A. Weinreb. "Can the Weight-Bearing Capacity of the Femoral Neck be Estimated by Physical Measurements on the Greater Trochanter?" Engineering in Medicine 17, no. 2 (April 1988): 59–62. http://dx.doi.org/10.1243/emed_jour_1988_017_018_02.

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Early detection of mechanical weakening of the femoral neck would help to prevent fractures at this site which are the most serious clinical problem in osteoporosis. In the vicinity of the femoral neck, the greater trochanter is a superficial bone structure more easily accessible to in vivo measurements. The purpose of the present study was to evaluate the relation between the strength of the femoral neck and the composition of the trabecular tissue in the greater trochanter. Twenty-nine fresh human intact femora were examined. The relationship between the average shear stress in failure of the femoral neck (ASS) and the Ca concentration (CC), mineral density (BMD), and overall mass density (BD) of the greater trochanter was investigated. Linear stepwise regression analysis showed that the ASS of the femoral neck can be predicted from the BD, CC, and BMD of the trochanteric tissue, and their contribution to the estimation of the ASS was ranked in the above order. The linear function relating the ASS to these variables showed a highly significant multiple correlation ( R = 0.87, p < 0.001). Therefore in vivo measurements of the density and mineral content in the greater trochanter should be considered useful in assessing the risk of fracture of the femoral neck.

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Pelet, Leyvraz, Garofalo, Borens, and Mouhsine. "Sub- or Intertrochanteric Fracture Following Screw Fixation of an Intracapsular Proximal Femoral Fracture: True Complication or Technical Error?" Swiss Surgery 9, no. 2 (April 1, 2003): 82–86. http://dx.doi.org/10.1024/1023-9332.9.2.82.

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Purpose: To review, retrospectively, the possible causes of sub- or intertrochanteric fractures after screw fixation of intracapsular fractures of the proximal femur. Methods: Eighty-four patients with an intracapsular fracture of proximal femur were operated between 1995 and 1998 by using three cannulated 6.25mm screws. The screws were inserted in a triangular configuration, one screw in the upper part of the femoral neck and two screws in the inferior part. Between 1999 and 2001, we use two screws proximally and one screw distally. Results: In the first series, two patients died within one week after operation. Sixty-four fractures healed without problems. Four patients developed an atrophic non-union; avascular necrosis of the femoral head was found in 11 patients. Three patients (3.6%) suffered a sub- and/or intertrochanteric fracture after a mean postoperative time of 30 days, in one case without obvious trauma. In all three cases surgical revision was necessary. Between 1999 and 2001 we did not observe any fracture after screwing. Conclusion: Two screws in the inferior part of the femoral neck create a stress riser in the subtrochanteric region, potentially inducing a fracture in the weakened bone. For internal fixation for proximal intracapsular femoral fracture only one screw must be inserted in the inferior part of neck.

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Samy, Tarek M., Tarek M. Khalil, Maged Abouelsoud, Amr Abdelrahman, and Mohamed B. Elghonimy. "Fracture Cascade in Patients with End-Stage Renal Disease: Complications and Outcome." Case Reports in Orthopedic Research 1, no. 1-3 (December 5, 2018): 55–61. http://dx.doi.org/10.1159/000495148.

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We report a 68-year-old end-stage renal disease female patient on dialysis for 15 years. She sustained consecutive fractures starting with left-sided femoral neck fracture, followed 16 months later by a right-sided one. On her recovery from her right hip injury she sustained a stress type subtrochanteric fracture at the entry site of the fixation implants and an ipsilateral humeral shaft fracture. Cementless total hip replacement was done for the left femoral neck, and osteosynthesis was done for her undisplaced right femoral neck fracture. Revision fixation was done for her right subtrochanteric fracture with a long Gamma nail that was statically locked. The humeral fracture was fixed with an interlocking nail in a closed manner. This case highlights the fact that sequential hip fractures is an ominous event which is likely to be followed by a quick cascade of bone injuries with trivial trauma and a high rate of unexpected complications. Our treatment approach is explained here, stressing the unexpected complications and challenges met.

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CHOU, WEN-HSIANG, and CHIEN-WEI LIU. "BIOMECHANICAL STUDY ON MECHANISMS OF FEMORAL NECK FRACTURE AFTER HIP RESURFACING ARTHROPLASTY." Journal of Mechanics in Medicine and Biology 19, no. 05 (August 2019): 1950042. http://dx.doi.org/10.1142/s0219519419500428.

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Hip resurfacing arthroplasty (HRA) is a long-established procedure. It is a minimally invasive surgery where the surgical wound is relatively small to facilitate a shorter recovery period. HRA remained a popular option among the patients allowing better range of motion of the joint compared to that of total hip arthroplasty (THA). Although HRA is associated with the above advantages, complications involving femoral neck fractures after surgery still occur. Therefore, the present study attempts to assess the impact of stress under various alignment conditions and different scenarios in surgical errors upon the femoral neck in hip resurfacing prostheses (HRP) that may be encountered during the procedure using finite element analysis (FEA) technique. The results showed that anteversion implantation errors on femoral components should be avoided, and that the main reason that causes femoral neck fracture is related to the stress shielding effect generated internally in the femoral neck. Methods to prevent the incidence of such events are a major obstacle to be solved in the future.

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Volpin, Gershon, Dory Hoerer, Gabriel Groisman, Samuel Zaltzman, and Haim Stein. "Stress Fractures of the Femoral Neck Following Strenuous Activity." Journal of Orthopaedic Trauma 4, no. 4 (December 1990): 394–98. http://dx.doi.org/10.1097/00005131-199004000-00005.

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Volpin, Gershon, Dory Hoerer, Gabriel Groisman, Samuel Zaltzman, and Haim Stein. "Stress Fractures of the Femoral Neck Following Strenuous Activity." Journal of Orthopaedic Trauma 4, no. 4 (December 1990): 394–98. http://dx.doi.org/10.1097/00005131-199012000-00005.

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39

Carpintero, P., F. Leon, M. Zafra, JA Serrano-Trenas, and M. Rom�n. "Stress fractures of the femoral neck and coxa vara." Archives of Orthopaedic and Trauma Surgery 123, no. 6 (July 1, 2003): 273–77. http://dx.doi.org/10.1007/s00402-003-0514-z.

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El-Sayed, Mostafa Abd El-Khalik, and Wael Ali Maher Mohammed El-Adl. "Insufficiency stress fractures of the femoral neck in children." European Journal of Orthopaedic Surgery & Traumatology 21, no. 8 (February 18, 2011): 579–85. http://dx.doi.org/10.1007/s00590-011-0765-2.

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41

Deng, Chen, Jason C. Gillette, and Timothy R. Derrick. "Measuring femoral neck loads in healthy young and older adults during stair ascent and descent." PLOS ONE 16, no. 1 (January 26, 2021): e0245658. http://dx.doi.org/10.1371/journal.pone.0245658.

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Understanding the hip loading environment for daily activities is useful for hip fracture prevention, rehabilitation, and the design of osteogenic exercises. Seventeen older adults (50–70 yrs) and twenty young adults (18–30 yrs) were recruited. A rigid body model combined with a musculoskeletal model was used to estimate lower extremity loading. An elliptical cross-section model of the femoral neck was used to estimate femoral neck stress during stair ascent and descent. Two peaks were identified in the stress curves, corresponding to the peaks in the vertical ground reaction force. During stair ascent, significantly higher tension on the superior femoral neck was found for the young group at peak 1 (young: 13.5±6.1 MPa, older: 4.2±6.5 MPa, p<0.001). Also during stair ascent, significantly higher compression on the posterior femoral neck was found for the older group at peak 2 (young: -11.4±4.9 MPa, old: -18.1±8.6 MPa, p = 0.006). No significant difference was found for stair descent. Components of stress (muscle vs. reaction forces; axial forces vs. bending moments) were also examined for each trial of stair ascent and descent. The stresses and their components provided loading magnitude and locations of higher stress on the femoral neck during stair ascent and descent. Understanding femoral neck stresses may be used to help prevent hip fractures, reduce pain, improve rehabilitation, and design osteogenic exercises.

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Lazarev, A. F., E. I. Solod, A. O. Ragozin, M. G. Kakabadze, A. F. Lazarev, E. I. Solod, A. O. Ragozin, and M. G. Kakabadze. "Treatment of Proximal Femur Fractures on the Background of Osteoporosis." N.N. Priorov Journal of Traumatology and Orthopedics 11, no. 1 (March 15, 2004): 27–31. http://dx.doi.org/10.17816/vto200411127-31.

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Analysis of treatment of 526 patients with proximal femur fractures (362 patients with femoral neck fractures and 164 patients with trochanteric zone fractures) was performed. Patients' age ranged from 34 to 92 (mean 67). Algorithm of differentiated choice of operative tactics depending on fracture characteristics and injury term was presented. Low invasive osteosynthesis of femoral neck with bundle of stressed V-shaped pins was suggested. Theoretical and practical ground of that technique was given. Stress within fixative-bone system created after osteosynthesis by V-shaped pins, provided stable fixation even in marked osteoporosis. The importance of bone mineral density evaluation for the choice of treatment tactics as well as the necessity of medicamental correction of the disturbed bone remodeling after surgical treatment was noted.

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Fabbri, Daniele, Riccardo Orsini, and Antonio Moroni. "Stress Fracture of Proximal Femur after Hip Resurfacing Treated with Cannulated Screw." Joints 06, no. 02 (June 2018): 128–30. http://dx.doi.org/10.1055/s-0038-1660815.

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AbstractStress fractures of the proximal femur are described in athletes and military personnel. In most cases, they are not treated surgically, except when they are at the top of the femoral neck and with cortical involvement. The return to sports is not recommended in patients with hip replacement, especially for the high rate of revision of implants in the younger patients. One of the major complications of hip resurfacing (HR) is the medial fracture of the femoral neck, which usually occurs within 9 weeks after surgery. The causes have to be attributed to a malposition of the femoral component or to an insufficient bone density. The case reported herein is unique because it describes a stress fracture on patient operated with HR, treated with screw fixation. Two years after surgery, the patient returned to his normal life, practicing sports, without progression of varus angulation of the stem.

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Khadabadi, Nikhil A., and Kiran S. Patil. "Simultaneous Bilateral Femoral Neck Stress Fracture in a Young Stone Mason." Case Reports in Orthopedics 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/306246.

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Unilateral stress fractures of the femoral neck are very uncommon and bilateral involvement is even rarer. They commonly occur in athletes, military recruits, older persons, or individuals with underlying metabolic disorders and very seldom in normal individuals. We present a rare case of simultaneous bilateral fracture neck of femur in a 25-year-old man who came with complaints of pain in bilateral groin for 1 month. There was no history of trauma or history suggestive of excessive activity prior to the onset of pain, but there was history of lifting heavy weights daily. On evaluation with MRI scan bilateral fracture of the femur neck was diagnosed and patient was operated on bilaterally with internal fixation done using dynamic hip screw. Patient then regained his routine activity over a period of 6 months and on follow-up at 1 year no avascular necrosis changes were seen in the femur head. We presented this case because of its unusual presentation and the diagnostic challenge it poses.

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Sensoz, Ersin, Fatih Mehmet Özkal, Volkan Acar, and Ferit Cakir. "Finite element analysis of the impact of screw insertion distal to the trochanter minor on the risk of iatrogenic subtrochanteric fracture." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 232, no. 8 (July 20, 2018): 807–18. http://dx.doi.org/10.1177/0954411918789963.

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Iatrogenic subtrochanteric fractures are rarely encountered after cannulated screw fixation of femoral neck fractures; however, when they do occur, there can be several complications. Many orthopedic surgeons have concerns about the potential for iatrogenic subtrochanteric fractures after screw fixation distal to the trochanter minor; therefore, some surgeons are typically reluctant to perform this procedure. This study focused on the risk of an iatrogenic subtrochanteric fracture after treating femoral neck fractures with cannulated screws. The main purpose of the study was to understand iatrogenic subtrochanteric fractures and evaluate the effects on these fractures of an inverted triangular–shaped configuration for placement of the cannulated screws. A femur bone with an femoral neck fracture at a 40° incline to the horizontal plane was generated along with a representation of a three-dimensional finite element model, and three inverted triangular–shaped configurations for placement of the cannulated screws were investigated using finite element analyses. Statistical results indicated that the occurrence risk of ISF increases when the screw is located distal to the trochanter minor. Moreover, the risk of occurrence of intertrochanteric fracture increases when the screw is located medial to the trochanter minor because of local concentrated stress on the surface of the screw canals. To avoid the vulnerability of the subtrochanteric region, it was found that proximal placement of the screws using the inverted triangular–shaped configuration could yield better results. In addition, the results of this study provide suggestions on improved screw configurations.

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Fonte, Hélder, and Ricardo Rodrigues-Pinto. "Femoral neck stress fracture in a young female recruit: case report." SICOT-J 4 (2018): 16. http://dx.doi.org/10.1051/sicotj/2018011.

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Introduction: Femoral neck stress fractures are uncommon and depending on their location, can be at high risk for non-union and significant morbidity. Their prevalence is higher among runners and military recruits, and women seem to be at higher risk. Methods: A 27-year-old female, who was enrolled in military recruit, reported left side groin pain after a strenuous running exercise. Due to persistent pain an X-Ray was ordered, which revealed no signs of acute lesions. Further imaging studies with CT scan and MRI identified a compression-type femoral neck stress fracture. Results: The patient was submitted to conservative treatment consisting of restricting from full weight-bearing. Six weeks after she initiated partial weight-bearing, becoming asymptomatic at seven months. Follow-up imaging studies revealed union of the fracture. Discussion: This diagnosis should be considered when evaluating military and athlete populations. Early recognition of these injuries is crucial because complication and morbidity rates are high.

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Li, Jiantao, Menglin Wang, Jianfeng Zhou, Lin Han, Hao Zhang, Chen Li, Lianting Li, and Ming Hao. "Optimum Configuration of Cannulated Compression Screws for the Fixation of Unstable Femoral Neck Fractures: Finite Element Analysis Evaluation." BioMed Research International 2018 (December 9, 2018): 1–10. http://dx.doi.org/10.1155/2018/1271762.

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Objectives. In the present study, we evaluated the mechanical outcome of different configurations of cannulated compression screws for the fixation of Pauwels type III femoral neck fracture and the stress distribution around the holes corresponding to fixation protocol after screws removal. Methods. The Pauwels type III of femoral neck fracture was created in 3-matic software and the models of cannulated compression screws were constructed using UG-NX software. Five fixation systems were assembled to the fracture models. Abaqus software was used to perform the process of finite element analysis. Values of stress distribution, maximum stress, model principal strains of proximal fragment, and stress distribution around the holes of femur model were recorded. Results. Stress of cannulated compression screws was intensely focused on the middle area of the screw near the fragment of each group. Inverted triangle model showed the highest peak stress on screws under different phases of load. Each screw dispersed some stresses, but at least one underwent the peak stress. Fracture model fixed by inverted triangle configuration showed the lowest volume of yielding strain in the proximal fragment. The area of higher stress around the holes was largest after triangle screws removal when compared with other four models. Conclusions. Our study indicated that different cannulated compression screws fixation configurations for the unstable femoral neck fractures showed the different mechanical efficiency. Inverted triangular configuration showed the mechanical advantage and being less likely to cutout. The fixation strategy of triangle configuration was least recommended if patients tended to remove the implants.

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Er, Mehmet S., Mehmet Eroglu, and Levent Altinel. "Femoral neck stress fracture in children." Journal of Pediatric Orthopaedics B 23, no. 2 (March 2014): 117–21. http://dx.doi.org/10.1097/bpb.0000000000000003.

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Maezawa, Katsuhiko, Masahiko Nozawa, Munehiko Sugimoto, Mihoro Sano, Katsuo Shitoto, and Hisashi Kurosawa. "Stress fractures of the femoral neck in child with open capital femoral epiphysis." Journal of Pediatric Orthopaedics B 13, no. 6 (November 2004): 407–11. http://dx.doi.org/10.1097/01202412-200411000-00012.

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Kusnezov, Nicholas A., Emmanuel D. Eisenstein, John C. Dunn, and Brian R. Waterman. "Functional Outcomes Following Surgical Management of Femoral Neck Stress Fractures." Orthopedics 40, no. 3 (January 31, 2017): e395-e399. http://dx.doi.org/10.3928/01477447-20170120-03.

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