Femoral neck stress fractures and metabolic bone disease.
OBJECTIVE
To determine whether metabolic bone disease plays a role in the cause of femoral neck stress fractures.


METHODS
Twenty-three patients with femoral neck stress fractures were enrolled prospectively in the study. Examination included computed tomography bone densitometry, trace mineral analysis, and histomorphometric analysis of the iliac crest in thirteen patients who underwent surgical treatment of their stress fractures. A control group of fifteen patients undergoing iliac crest bone grafting for scaphoid nonunions underwent similar examinations.


METHODS
Tertiary military medical center.


RESULTS
Patients with femoral neck stress fractures had lower bone mineral density than did control patients (p = 0.010), but no trace mineral deficiencies or consistent histomorphometric differences were noted.


CONCLUSIONS
Bone mineral density is decreased in patients with femoral neck stress fractures. Despite observations of decreased bone mineral density in the stress fracture group, osteoporosis, as determined by histomorphometry, is not a consistent finding.
Departments of Orthopedics and Clinical Research, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134-5000, U.S.A.
M P
MP
Muldoon
D E
DE
Padgett
D E
DE
Sweet
P A
PA
Deuster
G R
GR
Mack
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015519:Bone Density / Q000502:physiology; D001851:Bone Diseases, Metabolic / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D005265:Femoral Neck Fractures / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D015775:Fractures, Stress / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome