Pearls

  1. Compression/inferior side stress fractures with no fatigue line, no hip effusion and <50% of the femoral neck width are generally non-operative, but patients should be non-weight bearing for up to 6-weeks.
  2. Tension/superior side stress fractures, typically in older adults, are likely operative and patients must be non-weight-bearing. Consider admission.
  • Generally seen in young endurance athletes and military recruits.
  • MRI may be needed to diagnose the injury if there is a high suspicion and the initial x-rays are negative.
  • Can use crutches to keep patients non-weight bearing.

Complications

Progression to full fracture.