Femoral Neck Stress Fracture

[bmccasland]

Seems like being on crutches and avoiding surgery is a good thing. Have they done a bone density scan? Your femur should be a big strong bone, how the heck did you get a stress fracture in that bone? Will PT help?

[OakLeaf]

Ouch. Heal up quick.

[ruffianxc]

usually femoral neck hip fractures don't heal without pinning unless they are on a precise location that isnt' being pulled on and stressed by muscles. thats not saying you don't have that. I'm sure your doctor knows where your fracture is at but unless they are familiar with ortho cases they may not know. At least thats how I remember it from a couple years ago.

[kiwibug]

... Really??

Ugh. I have to make a decision - I'm at school now and the soonest an orthopedic surgeon can see me is November 17th, (he's away for a week and a half), but if I try to get in to see someone at home I could see someone sooner, but that's pretty inconvenient and I don't even know if I would be able to see someone sooner.

I was reading up, and I know that I have a compression type fracture (bottom part of the neck) and it's not displaced (it's not broken the whole way through), and usually they just treat it non-operatively - with limiting the weight-bearing and activity.. So I just figured I probably wouldn't need the surgery anyways?

I don't know. It's already been four weeks (and I didn't know what it was/that I shouldn't be walking on it so I have been) and it feels a lot better.. still sore at times but I'm not limping anymore (I've stopped taking pain meds because I want to be able to feel if it's hurting).

I'm not sure about why it's happened at that bone. I think that I haven't always made sure to eat properly (that is - enough calcium), and I have had some phases over the past few years where I've been really restrictive with my diet.. I've read a bit and it seems that female athletes that fall into the athlete triad category (osteoporosis, amenorrhea, disordered eating) are susceptible to stress fractures in the femoral neck.. I don't think I've ever had a real "eating disorder" and I'm not underweight, and I've had regular menstruation with the exception of a few months this past spring when I stopped taking the pill.. I don't know. I guess it could be a combination of a few things. I've started taking calcium though, I'm only 21 so I think I have some time to fix my bone density a bit.

I haven't had a bone density scan though.. I think it would probably give me more answers.

[KnottedYet]

As long as you're getting a density scan and such, you might also want a blood antibody test run to see if you have celiac disease. It can show up as bizarre symptoms, and often ties in with unusual bone issues.

[ruffianxc]

The patient I saw with this actually was about 20 years old and had an eating disorder. I saw another girl with an eating disorder who had several stress fractures and would not stop running.

Compression type is the good type if your avoiding surgery from what I remember. No guarantee no surgery but sounds better than what I originally thought.

However it won't heal as well if you don't have good nutrition.

Unless you get a couple stress fractures I don't think they need to test you for any endocrine or immune causes as there are lot with bone problems and it is most likely just a stress fracture caused by stress and diet from what you said. Those tests can get expensive and I don't think there would be enough concern of some underlying disease as you didn't mention other fractures.

I'm a 4th year med student and I shadowed in a sports medicine clinic for 2 years. I don't know a lot but I did see this.

[KnottedYet]

[QUOTE=ruffianxc;470987]

However it won't heal as well if you don't have good nutrition.

QUOTE]

Celiac disease is a disease whose myriad symptoms are a consequence of inadequate nutrition, aided and abetted by the autoimmune issues. One of the more exciting symptoms is osteopenia/osteoporosis at an unusually young age. If someone has been restricting the diet AND has a nutrient absorption issue (like celiac disease) they could experience heightened bone fragility beyond what would be expected with just one issue.

The screen is a simple blood draw, while the patient is still eating their average diet.

[KnottedYet]

I'm a 4th year med student and I shadowed in a sports medicine clinic for 2 years. I don't know a lot but I did see this.

It's amazing; the longer I practice, the less I know.

One valuable thing I've learned over the years: a patient will present with one problem, but most of the time that one problem has more than one cause. Patients with only one issue don't come in, their body copes so they don't seek medical help. When the body starts juggling multiple issues, it begins to drop things, and that's when problems show up.

I cringe when I think of the patients I misled and the issues I missed. And in all honesty, I'm probably still misleading and missing. That's why it's called "practice."