Abstract
This report presents a case of a displaced stress fracture of the femoral neck in an adolescent female distance runner with amenorrhea. Both reduction and internal fixation were performed early after the injury. At 24 months postoperatively, magnetic resonance imaging and bone scintigraphy showed no positive signs of femoral head necrosis and bone union was confirmed on plain X-ray. A medical examination for the presence of the signs of the female athlete triad by checking weight, calorie intake and menstrual cycles is most important to prevent such stress fractures. Athletes as well as their coaches or parents therefore need to understand female athlete triad.
Highlights
Stress fractures of the limbs frequently occur in adolescent female distance runners who develop amenorrhea, an eating disorder, and osteopenia, the so-called “female athlete triad” [1]
This report presents a case of a displaced stress fracture of the femoral neck in an adolescent female distance runner with “female athlete triad”
Her body mass index (BMI) was relatively low in comparison to these reports. Her follicular stimulating hormone (FSH) was 3.0 mIU/ml, and her luteinizing hormone (LH) was 2.1 mIU/ml, which indicated suppression of secretion from the pituitary gland, and her estradiol was 39.4 pg/ml, which indicated ovarian suppression. These results suggest that hypothalamic dysfunction due to physical and psychological factors cause primary amenorrhea
Summary
Stress fractures of the limbs frequently occur in adolescent female distance runners who develop amenorrhea, an eating disorder, and osteopenia, the so-called “female athlete triad” [1]. This report presents a case of a displaced stress fracture of the femoral neck in an adolescent female distance runner with “female athlete triad”. To the authors’ knowledge, this is the first case report that untreated female athlete triad caused a displaced stress fracture of the femoral neck in an adolescent female distance runner. Case presentation The patient was a 17-year-old female who had been a long distance runner for five years Her height was 160 cm, her weight was 47 kg, and her body mass index (BMI) was 18.4. She had run about 210 km a week during her junior high school years and 140 km a week during her high school years on a tartan track Her running form was the large stride type and her average time was 3 minutes and 40 seconds per kilometer. Was no evidence of necrosis of the femoral head on plain X-ray at 24 months after the injury (Figure 5), and she returned to the same runner level before the injury with no complaints
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