Bilateral stress fractures of the femoral neck in adults: a case report

The concurrent bilateral stress fractures of the femoral neck (SFFN) are extremely rare injuries in individuals without excessive bone activities. We present a case with compression type stress fracture in the right femoral neck, and displaced type stress fracture in the left femoral neck which might progress from an undiagnosed tension type fracture. Based on the findings of the literature review and our experience, we developed a strategy for early diagnosis and appropriate treatment of SFFN in adult patients. Early diagnosis along with immediate interventions might prevent serious complications. Plain radiographs could often confirm the diagnosis, but if not bone scan, MRI and occasionally CT scan could provide more information in detecting stress fractures. If the fracture is the compression type, we strongly recommend an additional CT scan for detection occult tension-type fracture. Treatment should be based on the classification of the fracture and the risk of exacerbation or serious complications.