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Orthopaedics · Fractures: femoral neck stress fracture
Sample itemA 22-year-old marathon runner has groin pain on running, and an MRI shows a stress fracture on the superolateral (tension) side of the femoral neck. What is the best management?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Urgent surgical fixation to prevent displacement
Tension-side femoral neck stress fractures have a high risk of displacement and subsequent avascular necrosis, so they are fixed with screws without delay. Compression-side (inferomedial) fractures, if small, can often be managed with protected weight bearing. Continuing to run risks complete fracture.
Option by option
A. Continue running with analgesia
Running worsens the fracture and may cause displacement.
B. Total hip replacement
Replacement is excessive for a young runner with an undisplaced fracture.
C. Protected weight bearing alone for two weeks
Short protected weight bearing is not adequate for a tension-side fracture.
D. Urgent surgical fixation to prevent displacement (correct)
Correct. Tension-side fractures are fixed urgently because they tend to displace.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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