Proximal Femoral Stress Reaction in A Military Recruit - A Treatment Prospect.
BACKGROUND
Stress fractures occur in individuals in whom repetitive strenuous muscle and tendon force act on bone; that have not adapted to such forces. Under a constant load, osteoclast resorption and osteoblastic reconstruction of bone are in equilibrium, resulting in normal remodeling. If loading increases, additional bone resorption occurs. Increased osteoclastic activity at sites of stress may cause local weakening and predispose to micro damage. If allowed to progress, such micro fractures may progress to complete fractures.


METHODS
A 30-year-old man presented with right thigh pain for 3 days without any history of significant trauma. He was a military recruit with history of running 5 miles a day for last 12 years and was running 20 miles a day for last 5 days before he developed pain. Examination revealed pain to palpation along the proximal medial and lateral right thigh. Range of motion was painful and limited. Radiograph of right hip showed fracture line in intertrochanteric region of femur.


CONCLUSIONS
Here we have reported a case of stress fracture of proximal femur in intertrochanteric region which to our knowledge has not been reported in the literature so far. This fracture is important to recognize early as there are high chances of displacement resulting in increased risk of complications. We suggest immediate anatomical reduction and stable internal fixation to prevent complications and early mobilization to decrease the morbidity.
Central Institute of Orthopaedics, VMMC & Safdarjung Hospital, New Delhi, India.
Mohit
M
Garg
Central Institute of Orthopaedics, VMMC & Safdarjung Hospital, New Delhi, India.
Surendar
S
Kumar
Central Institute of Orthopaedics, VMMC & Safdarjung Hospital, New Delhi, India.
Hemendra Kumar
HK
Agrawal
Central Institute of Orthopaedics, VMMC & Safdarjung Hospital, New Delhi, India.
Ashish
A
Jaiman
Insufficiency fracture; Intertrochanteric; Osteoblast; Osteoclast; Osteonecorsis