Bilateral Femoral Neck Stress Fractures in a Healthy Young Military Report and Review of Literature.
- 1Department of Orthopedic Surgery, Mercer University School of Medicine, Columbus, Georgia.
- 2Department of Orthopedic Surgery, Hughston Trauma, Columbus, Georgia.
Abstract
Femoral neck stress fractures (FNSF) account for approximately 5% of stress fractures in young adults and are typically associated with repetitive high-impact activities, such as running and jumping. Bilateral FNSF are rare, with few reported cases in otherwise healthy individuals. We present a 22-year-old military trainee who sustained bilateral femoral neck fractures following increased activity and jumping off an obstacle course during training. He noted the acute onset of pain and could no longer ambulate. Imaging demonstrated a non-displaced right femoral neck fracture and a displaced left femoral neck fracture. The right hip was treated with closed reduction and percutaneous screw fixation, while the left fracture was stabilized by open reduction and internal fixation with a Femoral Neck System. Early post-operative imaging revealed varus malalignment of the left femur, requiring revision with a subtrochanteric valgus osteotomy and blade plate fixation. Metabolic evaluation revealed vitamin D deficiency and mildly low testosterone, highlighting an underlying bone health risk despite an otherwise unremarkable history. Delayed diagnosis and treatment of FNSF significantly increases the risk of displacement, non-union, and avascular necrosis. Early use of advanced imaging, particularly magnetic resonance imaging, is critical when clinical concern persists despite negative radiographs. Surgical management should emphasize anatomic reduction and fixation, with valgus osteotomy serving as an effective salvage technique in cases of varus malalignment. This case underscores the importance of clinical suspicion, imaging, and optimized initial surgical management to minimize complications. In addition, it highlights a gap in current military screening protocols, emphasizing the need for routine assessment of bone health and metabolic risk factors prior to high-intensity training. Implementation of targeted screening and prevention strategies may reduce the incidence of these potentially devastating injuries in high-risk populations.
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BibTeX
@article{jones2026bilateral,
title = {{Bilateral Femoral Neck Stress Fractures in a Healthy Young Military Report and Review of Literature.}},
author = {Aneesa Jones and John Floyd},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8416},
url = {https://europepmc.org/article/MED/42997178},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Bilateral Femoral Neck Stress Fractures in a Healthy Young Military Report and Review of Literature.
AU - Aneesa Jones
AU - John Floyd
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8416
UR - https://europepmc.org/article/MED/42997178
AB - Femoral neck stress fractures (FNSF) account for approximately 5% of stress fractures in young adults and are typically associated with repetitive high-impact activities, such as running and jumping. Bilateral FNSF are rare, with few reported cases in otherwise healthy individuals. We present a 22-year-old military trainee who sustained bilateral femoral neck fractures following increased activity and jumping off an obstacle course during training. He noted the acute onset of pain and could no longer ambulate. Imaging demonstrated a non-displaced right femoral neck fracture and a displaced left femoral neck fracture. The right hip was treated with closed reduction and percutaneous screw fixation, while the left fracture was stabilized by open reduction and internal fixation with a Femoral Neck System. Early post-operative imaging revealed varus malalignment of the left femur, requiring revision with a subtrochanteric valgus osteotomy and blade plate fixation. Metabolic evaluation revealed vitamin D deficiency and mildly low testosterone, highlighting an underlying bone health risk despite an otherwise unremarkable history. Delayed diagnosis and treatment of FNSF significantly increases the risk of displacement, non-union, and avascular necrosis. Early use of advanced imaging, particularly magnetic resonance imaging, is critical when clinical concern persists despite negative radiographs. Surgical management should emphasize anatomic reduction and fixation, with valgus osteotomy serving as an effective salvage technique in cases of varus malalignment. This case underscores the importance of clinical suspicion, imaging, and optimized initial surgical management to minimize complications. In addition, it highlights a gap in current military screening protocols, emphasizing the need for routine assessment of bone health and metabolic risk factors prior to high-intensity training. Implementation of targeted screening and prevention strategies may reduce the incidence of these potentially devastating injuries in high-risk populations.
SN - 2250-0685
SN - 2321-3817
ER -