The Subcapital Femoral Neck Stress Fracture: A Novel Subtype of Compression-sided Stress Fracture-A Report of Three Cases

Francesco Biolzi; Ryan Dinnen; Bonamico Jacobs; Tyler Doty; Colleen Barkley; Keith Lynn Jackson; K Aaron Shaw

doi:10.1093/milmed/usac304

The Subcapital Femoral Neck Stress Fracture: A Novel Subtype of Compression-sided Stress Fracture-A Report of Three Cases

Mil Med. 2022 Oct 13:usac304. doi: 10.1093/milmed/usac304. Online ahead of print.

Authors

Francesco Biolzi¹, Ryan Dinnen², Bonamico Jacobs¹, Tyler Doty³, Colleen Barkley⁴, Keith Lynn Jackson^{1

5}, K Aaron Shaw^{1

5}

Affiliations

¹ Department of Orthopaedic Surgery, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA 30905, USA.
² College of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA.
³ West Virginia School of Osteopathic Medicine, Lewisburg, WV 24901, USA.
⁴ Department of Physical Therapy, Moncrief Army Community Hospital, Columbia, SC 29207, USA.
⁵ Department of Surgery, Uniformed Services University of Health Sciences, Bethesda, MD, USA.

PMID: 36226755
DOI: 10.1093/milmed/usac304

Abstract

Femoral neck stress fractures (FNSFs) are increasingly common, particularly in military training. The usual mode of classifying these injuries is based on the involvement of the compression or tension side of the femoral neck; however, this may oversimplify and fail to address factors such as the orientation of the fracture line. We present a novel subtype of a compression-sided FNSF affecting the subcapital femoral neck and report the treatment outcomes in a military trainee population. A retrospective analysis of patients with a subcapital, compression-sided FNSF was identified from a single U.S. Army basic trainee installation. Radiographic evaluation as well as treatment outcomes associated with the ability to complete military training were reported. A total of three patients with a subcapital compression-sided FNSF were identified in a military trainee population, accounting for 10% of all FNSFs that developed over a 3-month period. Of these individuals, one was treated operatively while the other two were treated non-operatively. Overall, one patient was able to return to and successfully complete military training.

Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2022. This work is written by (a) US Government employee(s) and is in the public domain in the US.