title: Stress fracture of the proximal femur after screw removal.
abstract: We describe a case of stress fracture of the proximal femur occurring in a patient after removal of an internal fixation device for a comminuted subtrochanteric fracture. The presenting clinical picture resembled a late postoperative infection with a positive technetium and gallium bone scan and normal radiological findings. The stress fracture occurred after removal of the fixation device when the patient started full weight-bearing. The patient was treated initially as having osteomyelitis until a second X-radiograph some weeks later demonstrated a stress fracture through one of the previous screw holes. This case illustrates well the possible complication of a insufficiency fracture subsequent to the occurrence of stress risers through screw holes in a weakened bone when submitted to normal load. The clinical presentation may sometimes resemble late postoperative infection.
authors.affiliation: Department of Orthopaedic Surgery, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Velkes
authors.forename: J
authors.initials: J
authors.lastname: Nerubay
authors.forename: F
authors.initials: F
authors.lastname: Lokiec
mesh_terms: D000328:Adult; D001863:Bone Screws; D005264:Femoral Fractures / Q000209:etiology*; D018460:Fractures, Comminuted / Q000601:surgery; D015775:Fractures, Stress / Q000209:etiology*; D006620:Hip Fractures / Q000601:surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications