• cephalomedullary nailing
• endurance athletes
• femoral neck stress fractures
• military
• return to sport

• AFMC - 2024 - KMMRP - 002 Armed Forced Medical Command
• AFMC - 2024 - KMMRP - 002 Armed Forced Medical Command

• FNSF
• femoral neck
• stress fractures
• young adults

• funding

• Age
• Anterior acetabular sector angle
• Risk factors
• Subchondral fatigue fracture of the femoral head

• Fibrous dysplasia
• anatomic classification
• femoral neck shaft angle
• fracture
• osteocalcin
• proximal femur
• risk factor

Fractures of the proximal femur epiphysis are problematic for state health care because they are associated with severe medical and social problems and high morbidity and mortality rates.

To model the potential risk of hip fracture via femur geometric parameters.

Seventy educational cadaveric femurs from people aged 14 to 80 years, 10 X-ray images from the records of the Human Anatomy Department and 10 X-ray images from the Department of Traumatology, Orthopedics and Disaster Surgery of Sechenov University, were evaluated. The parameters of the fractured bone were measured using images captured with a Canon d60 camera. The projection values of the proximal epiphysis of the cadaveric femurs and geometric parameters of the bones shown in the X-ray images were measured with Autodesk software (AutoCAD 2018). Analysis of the video frames showing bone rotation reveal that the greater trochanter can be inscribed in a parallelepiped, where one of the faces is parallel to the plane of view in the frontal standard projection and is rectangular. The angle of bone rotation obtained by turning the cube corresponded to the angle measured with the second technique. This reliable method of calculating the rotation of the bone relative to the anterior projection was employed in subsequent calculations. The geometric parameters of the femur were measured using X-ray images according to the proposed method.

The geometric parameters of 70 femurs were analyzed, and correlation coefficients were calculated. Our measurement results were compared with those reported by other authors. The potential influence of femur geometry on force distribution in the proximal epiphysis of the femur was described, and a 2-dimensional model of the femur epiphysis associated with minimal neck fracture risk was provided. The assessment of the geometric parameters of the femoral epiphysis indicated the greatest risk of a varus fracture of the neck if the angle of the minimal resistance zone (AMRZ) index > 24° and the neck-shaft angle (NSA) < 127.5°. In contrast, the minimum risk was observed at AMRZ < 14° and NSA > 128.87°.

The proposed method provides the potential femur neck fracture risk based on geometric parameters.

• Fracture
• Proximal epiphysis of femur
• Risk
• Traumatology
• Hip neck
• Risk assessment scale

Stress fractures of the femoral neck are not common in clinical practice, and simultaneous stress fractures of the femoral neck and proximal femur of the unilateral femur are even more rare. We introduce a case of this type of fracture that was treated in our department, analyze the causes, and review similar stress fractures reported in the literature to provide references for the diagnosis and treatment of such conditions.

A 62-year-old female, with a free medical history, was admitted to the hospital mainly due to pain in the right hip and worsening pain in the right thigh. The patient had no obvious history of trauma. X-ray and computed tomography showed fracture of the femoral neck and proximal femur. The patient had undergone surgery 1 year prior to address a fracture of the left proximal femur that had occurred in a traffic accident. Our first consideration was stress fracture of the femoral neck; however, simultaneous stress fractures of the femoral neck and proximal femur of the unilateral femur were seen. The femoral neck stress fracture was a tension fracture, with obvious displacement and varus deformity of the hip. Considering that the patient was an elderly female, we performed total hip arthroplasty. Follow-up X-rays showed that the stress fracture of the proximal femur had mostly healed after 3 mo.

Muscle fatigue and hip varus deformity provide an anatomical basis for the occurrence of femoral neck stress fractures.

• Femoral neck fracture
• Femoral fracture
• Stress fracture
• Fatigue fracture
• Hip pain
• Case report

• Femoral Neck Fractures/diagnosis
• Femoral Neck Fractures/etiology
• Femoral Neck Fractures/surgery
• Femur Head
• Femur Neck
• Fracture Fixation/methods
• Fracture Fixation, Internal/methods
• Fractures, Stress/diagnosis
• Fractures, Stress/etiology
• Fractures, Stress/surgery
• Humans