Femoral Neck Stress Fractures in Athletes and the Military

Femoral neck stress fractures (FNSFs) are an infrequent condition in athletic and military populations. A high index of suspicion with liberal use of magnetic resonance imaging (MRI) is vital for early recognition and treatment initiation. An associated hip effusion on MRI is a risk factor for an evolving stress injury and requires close assessment and consideration for repeat MRI. Stress reactions and stable, incomplete FNSFs (<50% of femoral neck width) can be treated nonsurgically. Surgical intervention is accepted for high-risk, incomplete (>= 50% of femoral neck width), and complete FNSFs. Overall, there is a paucity of high-quality literature on the rates of return to activity following FNSF.