Femoral neck stress fractures: outcome analysis at minimum five-year follow-up.

INTRODUCTION: The complications associated with misdiagnosed or undertreated femoral neck stress fractures in young, active adults have been well documented in the orthopaedic literature. Less is known regarding the outcome of these injuries in patients whose diagnosis was timely and whose treatment was appropriate.

METHODS: A sample of 25 patients previously involved in an unrelated study evaluating femoral neck stress fractures were contacted retrospectively 5 to 7 years after their injury. They were asked to complete a self-administered outcome evaluation, the Musculoskeletal Function Assessment (MFA), and answer several specific questions regarding their hips at the present time. Their MFA score was compared with treatment method, fracture type, and bone mineral density (BMD).

RESULTS: All 25 patients responded to our inquiries. Of patients, 68% continued to feel "somewhat bothered" by their injury in at least one functional category. Nine patients felt "disabled." No patient has developed avascular necrosis, nonunion, malunion, or posttraumatic arthrosis or was currently under the care of an orthopaedic surgeon. Nine patients had developed stress fractures in other locations. The mean MFA score was 18.80 (range 0 to 63). A lower score corresponds to a patient's perceived higher level of function. Analysis of MFA scores did not reflect statistically significant differences between fracture location, treatment modality, or BMD.

CONCLUSIONS: Femoral neck stress fractures can result in devastating problems for young adults. Appropriately treated patients, regardless of treatment method, may have persistent complaints.