新兵集训致股骨颈应力性骨折3例并文献复习

Stress fractures of femoral neck in recruits: a report of three cases and literature review

股骨颈应力性骨折十分少见,在所有青年人群应力性骨折中发病率接近5%。这种骨折在运动员、入伍新兵和代谢系统疾病患者中相对常见。由于治疗过程中存在的并发症,股骨颈应力性骨折的治疗方法仍然存在争议。本院收治了3例4侧新兵战士发生股骨颈应力性骨折的病例,3例患者均已排除可能导致病理性骨折的相关代谢性疾病,如骨质疏松症、糖尿病等。3例患者经闭合复位空心钉内固定术治疗后正常出院。平均随访时间1年半,最长达3年,随访期间未发现患肢出现股骨头坏死、骨性关节炎的表现。对于新兵出现逐渐加重的非特异性髋部疼痛等症状应引起足够重视,避免发生股骨颈应力性骨折,尽可能降低伤退役率。对于有移位的股骨颈应力性骨折,应早期积极的手术治疗,以达到更好的预后。

Femoral neck stress fractures（ FNSFs） are rare,constituting only 5% of all stress fractures in young adults.These fractures are usually seen in athletes,military recruits and patients with underlying metabolic diseases. The treatment of FNSFs is still controversial because of the inherent complications associated with the treatment procedure. In this paper,we reported 3 cases（ 4 sides） of FNSFs. All fractures were excluded metabolic disease such as osteoporosis,diabetes mellitus which may lead to pathological fractures. Three patients with allotopia after fracture on evey side was managed by cannulated screw fixation before nomal discharge. Average follow- up time was one and a half years,up to 3 years,No evidence of avascular necrosis or arthritis was noted in our series. Attention should be paid for recruits who appeared gradually increasing atypical hip pain. Any suspected patients should seek medical advice timely to avoid the occurrence of the femoral neck stress fractures. Furthemore,an early and aggressive surgical approach can result in an optimal outcome.