Bilateral displaced femoral neck stress fractures treated with valgus subtrochanteric osteotomy: A case report and two-year follow-up

Abstract

Bilateral femoral neck stress fractures are uncommon injuries that are successfully treated with surgical treatment; however, there is a high complication rate, as well as the challenging issue of the joint preserving procedure. This study reports the rare case of simultaneous valgus subtrochanteric osteotomy with a satisfactory outcome. A twenty-year-old male military recruit, with no history of previous hip pain or significant injury, presented with gradually progressive bilateral hip pain for three months after recruitment into military training. He was unable bear weight on both hips for one day prior to hospital without risk of sudden injury. A preoperative radiograph revealed displaced bilateral femoral neck fractures, and magnetic resonance imaging (MRI) demonstrated no evidence of avascular necrosis of the femoral heads. A bilateral valgus subtrochanteric osteotomy procedure was simultaneously and successfully performed on both hips. Six months after surgery, the patient was able to walk independently without any complications, and radiographic unions were presented. The two-year follow up radiographs showed no evidence of avascular necrosis of the femoral heads. The valgus subtrochanteric osteotomy procedure is an effective joint preserving procedure in femoral neck stress fractures, including the uncommon bilateral cases.