title: Bilateral femoral neck stress fractures in military recruits with unilateral hip pain.
abstract: Femoral neck stress fractures are rare and can be easily missed and failure to diagnose these injuries early can lead to avascular necrosis, malunion and osteoarthritis. It is important to have a high index of suspicion for femoral neck stress fractures in military recruits. We present three cases of bilateral femoral neck fractures in military recruits, all presenting with unilateral hip symptoms and signs. All the asymptomatic contralateral hips had femoral neck stress fractures diagnosed by screening MRI. Tension type and displaced femoral neck fractures were treated surgically. All the fractures managed healing without complications. Military recruits with unilateral groin pain should have an early referral for MRI hip to rule out femoral neck stress fractures and those military personnel with ipsilateral femoral neck fracture should have MRI of the contralateral hip. Two of the patients had vitamin D deficiency, of which one had elevated parathyroid hormones and low bone mineral density. Our case series highlights the significance of vitamin D deficiency among military recruits.
authors.affiliation: Department of Orthopaedics Surgery, Changi General Hospital, Singapore, Singapore.
authors.forename: Ing How
authors.initials: IH
authors.lastname: Moo
authors.affiliation: Department of Orthopaedics Surgery, Changi General Hospital, Singapore, Singapore.
authors.forename: Y H D
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Orthopaedics Surgery, Changi General Hospital, Singapore, Singapore.
authors.forename: K K
authors.initials: KK
authors.lastname: Lim
authors.affiliation: Department of Orthopaedics Surgery, Changi General Hospital, Singapore, Singapore.
authors.forename: K V
authors.initials: KV
authors.lastname: Mehta
mesh_terms: D000293:Adolescent; D018771:Arthralgia / Q000000981:diagnostic imaging* / Q000209:etiology; D005265:Femoral Neck Fractures / Q000150:complications / Q000000981:diagnostic imaging*; D015775:Fractures, Stress / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008889:Military Personnel; D009104:Multiple Trauma / Q000150:complications / Q000000981:diagnostic imaging*; D011859:Radiography; D014808:Vitamin D Deficiency / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult
keywords: ORTHOPAEDIC & TRAUMA SURGERY