Abstract
ObjectiveTo evaluate the influences of the femoral neck shaft angle (FNSA) on the location of the femoral stress fracture and to assess the potential differences in FNSA between fractured and normal femurs.Materials and methodsThirty-seven patients with femoral stress fractures who underwent both plain hip radiographs and MRI, from January 2016 to September 2019, were retrospectively included. Patients were classified as having either femoral head stress fracture (group A, n = 26) or femoral neck stress fracture (group B, n = 11). The FNSA was measured in anteroposterior (AP) hip radiograph. The Mann-Whitney U testing was used to compare the continuous values between the two groups. A receiver operating characteristic (ROC) analysis was used to evaluate the value of FNSA for predicting the risk of femoral stress fracture.ResultsThe FNSA was significantly higher in group A (median 135.9°, range 129.5–138.6°) than group B (median 124.3°, range 119.5–129.0°) (p < 0.001), but there were no significant differences in other clinical factors. Furthermore, the FNSA was significantly higher at the fractured femurs (median 135.9°, range 129.9–138.6°) than contralateral normal femurs (median 127.9°, range 123.8–132.1°) in the patients with unilateral femoral head stress fracture (n = 22) (p < 0.001). The ROC analysis revealed that the area under curve (AUC), sensitivity, and specificity for predicting the risk of femoral head stress fracture were 0.807, 72.7%, and 68.2%, respectively, at a FNSA cutoff of 131.0°.ConclusionFNSA was associated with the location of the femoral stress fracture. In addition, FNSA could serve as a predictive factor for the risk of femoral head stress fractures.
Highlights
Femoral stress fractures occur in individuals of all ages but can impact young individuals who engage in physical activities such as running
Group A: 26 patients with 30 femoral head fractures, Group B: 11 patients with 11 femoral neck fractures BMI, body mass index; F/U, follow-up; numeric rating scale (NRS), numeral rating scale; FNSA, femoral neck shaft angle *Results of continuous values are expressed as the median with interquartile range (25–75%) **Time interval: interval periods from the clinical visit to magnetic resonance imaging (MRI) examination
The influence of FNSA in relation to femoral stress fracture was evaluated in military recruits controlled for most of the known risk factors for femoral stress fracture, Table 2 Evaluation of FNSA between the fractured femur and the contralateral normal femur in the same patient: 22 patients with unilateral femoral head stress fractures and 11 patients with unilateral femoral neck stress fractures
Summary
Femoral stress fractures occur in individuals of all ages but can impact young individuals who engage in physical activities such as running. This is because pathophysiologically lower extremity bone stress injury is a type of overuse injury [1,2,3]. While military recruits, who consist of healthy young men, Other than those extrinsic and intrinsic factors associated with stress fractures, some previous studies reported that hip geometry could serve as an intrinsic factor related to femoral stress fractures [7, 8]. To our knowledge, no prior studies have determined
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
