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Dr. Ebraheim’s educational animated video describes stress fractures of the femoral neck. Stress fractures of the femoral neck are most commonly seen in athletes such as runners. Females are more common than males to experience stress fractures of the femoral neck. Female athletic triad Eating disorders Osteoporosis Amenorrhea Beware of female runner with pain in the groin and normal x-rays. Compression fracture appears 6 weeks later on x-rays. Clinical findings Groin pain Pain with weight-bearing activity Negative x-ray in about 2/3 of the patients MRI is the best study Exclude other casues of hip pain such as transient osteoporosis and avascular necrosis. Types of stress fractures Compression fracture Callus at the inferior aspect of the femoral neck If the fracture involves less than 50% of femoral neck, it can be treated with non-weight bearing and crutches as well as restricted activity. If the fracture involves more than 50% of femoral neck, it should be treated with screw fixation. Tension fracture Fracture at the superior aspect of the femoral neck. Adult bone is weak in tension With tension the fracture will propagate Treatment should be given with screw fixation Displaced fracture Will have bad prognosis especially with younger patients Risk of avascular necrosis and nonunion with displaced fracture. Emergency in young patients Do reduction and screw fixation. Elderly patient with groin pain and normal x-ray: obtain MRI to rule out a stress fracture. Use prosthesis in elderly. Become a friend on facebook: / drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC