Stress fractures of the femoral shaft in women's college lacrosse: a report of seven cases and a review of the literature.

BACKGROUND Stress fractures do not often occur in the shaft of the femur. They are more common in the femoral neck, the tibial shaft, the metatarsals, and other bones of the foot. In female athletes, stress fractures classically afflict the distance runner, the ballerina, the gymnast, and the figure skater. OBJECTIVES To describe the clinical presentation, diagnosis, treatment, and outcome of seven college female lacrosse players with femoral shaft stress fractures, and review the literature. RESULTS The unusual results of this study support the principle that clinical suspicion should be high when treating any female athlete regardless of the sport. In this case series, an abrupt change in the quality of the running surface during the competitive training season was the only underlying common thread among the athletes. CONCLUSION The findings suggest that risk factors for the female athlete are variable and are no longer limited to the undernourished or overtrained.