CC BY-NC-ND 4.0 · Sports Med Int Open 2017; 01(02): E58-E68
DOI: 10.1055/s-0043-103946
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Femoral Neck Stress Fractures in Sport: A Current Concepts Review

Greg A. Robertson
1   Edinburgh Orthopaedic Trauma Unit, Department of Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland
Alexander M. Wood
2   Bristol Royal Infirmary, Department of Orthopaedics, Bristol, United Kingdom of Great Britain and Northern Ireland
› Author Affiliations
Further Information

Publication History

received 15 October 2016
revised 30 January 2017

accepted 02 February 2017

Publication Date:
15 March 2017 (online)


Femoral 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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