eMedicine Specialties > Sports Medicine > Hip

Femoral Neck Fracture: Follow-up

Author: Gerard A Malanga, MD, Founder and Director, New Jersey Sports Medicine Institute; Director of Pain Management, Overlook Hospital; Director of Sports Medicine, Sports Medicine Fellowship Director, Mountainside Hospital; Clinical Chief, Rehabilitation Medicine and Electrodiagnosis, St Michael's Medical Center; Medical Director, Consultant, Horizon Healthcare Worker's Compensation Services, Blue Cross and Blue Shield Worker's Compensation
Coauthor(s): Neil N Jasey, Jr, MD, Staff Physician, Department of Physical Medicine and Rehabilitation, Kessler Institute for Rehabilitation, University of Medicine and Dentistry of New Jersey; Jennifer Solomon, MD, Staff Physician, Department On Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey
Contributor Information and Disclosures

Updated: Jan 28, 2009

Follow-up

Return to Play

Return-to-play criteria in patients following femoral neck fractures require the athlete to have an absence of signs or symptoms of the original injury, full range of motion, normal strength and flexibility, and normal sport-specific mechanics. Athletes must be aware of their own limitations, which is particularly important for the individual gradually returning to a competitive level of activity after injury.

Complications

Complications include recurrent stress fractures.

Prevention

Patient education is an important factor in the prevention of stress fractures. Female athletes should decrease their risk of recurrent fractures by maintaining adequate muscle mass and bone density.

Maintaining proper flexibility is also thought to play a significant role in the prevention of sports-related injuries. Additionally, improvement in aerobic fitness can increase blood flow and oxygenation to all tissues, including the muscles and bones, and it would be a reasonable addition to any rehabilitation and prevention program. Seasonal athletes should be encouraged to cross-train all year or at least undergo preconditioning before participating in their particular sport.

Prognosis

Depending on the nature of the fracture, the athlete may or may not return to premorbid functioning. A displaced stress fracture of the femoral neck may end the career of an elite athlete even if correctly treated. Early diagnosis and treatment may prevent displacement of the fracture and thus improve the prognosis.

Education

The patient with a femoral neck fracture should have a good understanding of his or her diagnosis and the benefits and risks of treatment. Completing education throughout the rehabilitation process is very important for patients to obtain the most optimal results and to possibly to return to their previous level of activity or specific sport.

Patients should take an active role in their care and understand what is necessary for proper healing, in addition to being instructed in a home exercise program for regaining their strength and range of motion of the affected lower extremity. Patient education is crucial to the prevention of recurrent neck stress fractures.

Miscellaneous

Medicolegal Pitfalls

  • The diagnosis of a femoral neck stress fracture requires a high index of suspicion, which can be fostered on the basis of findings from a thorough history and physical examination and proper imaging studies. Groin pain can also be referred from the pelvis. Patients presenting with groin pain, especially in those who have pain during ambulation, should always undergo a thorough hip evaluation. Proper imaging must be completed to rule out a displaced fracture, which is a surgical emergency in young athletes. Tension fractures are potentially unstable and require operative stabilization. A missed tension fracture can lead to potential complications of fracture displacement, osteonecrosis, malunion, or nonunion.
 


More on Femoral Neck Fracture

Overview: Femoral Neck Fracture
Differential Diagnoses & Workup: Femoral Neck Fracture
Treatment & Medication: Femoral Neck Fracture
Follow-up: Femoral Neck Fracture
Multimedia: Femoral Neck Fracture
References
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References

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Further Reading

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Keywords

femoral neck fracture, stress fractures of the femoral neck, femur head fracture, hip fracture, leg fracture, broken leg, broken hip, femoral neck stress fracture, hip stress fracture, stress fracture, leg stress fracture, osteoporosis, miserable malalignment syndrome, leg-length discrepancy, female athlete triad, Garden classification, leg length discrepancy, leg length

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Contributor Information and Disclosures

Author

Gerard A Malanga, MD, Founder and Director, New Jersey Sports Medicine Institute; Director of Pain Management, Overlook Hospital; Director of Sports Medicine, Sports Medicine Fellowship Director, Mountainside Hospital; Clinical Chief, Rehabilitation Medicine and Electrodiagnosis, St Michael's Medical Center; Medical Director, Consultant, Horizon Healthcare Worker's Compensation Services, Blue Cross and Blue Shield Worker's Compensation
Gerard A Malanga, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, North American Spine Society, and Physiatric Association of Spine, Sports and Occupational Rehabilitation
Disclosure: Nothing to disclose.

Coauthor(s)

Neil N Jasey, Jr, MD, Staff Physician, Department of Physical Medicine and Rehabilitation, Kessler Institute for Rehabilitation, University of Medicine and Dentistry of New Jersey
Disclosure: Nothing to disclose.

Jennifer Solomon, MD, Staff Physician, Department On Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey
Jennifer Solomon, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Physical Medicine and Rehabilitation, and Medical Society of the State of New York
Disclosure: Nothing to disclose.

Medical Editor

Janos P Ertl, MD, Assistant Professor, Department of Orthopedic Surgery, Indiana University School of Medicine; Chief of Orthopaedic Surgery, Wishard hospital
Janos P Ertl, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Hungarian Medical Association of America, and Sierra Sacramento Valley Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Russell D White, MD, Professor of Medicine, Department of Community and Family Medicine, University of Missouri-Kansas City School of Medicine, Truman Medical Center Lakewood
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD, Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago
Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

 
 
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