Abstract
We describe a case of stress fracture of the proximal femur occurring in a patient after removal of an internal fixation device for a comminuted subtrochanteric fracture. The presenting clinical picture resembled a late postoperative infection with a positive technetium and gallium bone scan and normal radiological findings. The stress fracture occurred after removal of the fixation device when the patient started full weight-bearing. The patient was treated initially as having osteomyelitis until a second X-radiograph some weeks later demonstrated a stress fracture through one of the previous screw holes. This case illustrates well the possible complication of a insufficiency fracture subsequent to the occurrence of stress risers through screw holes in a weakened bone when submitted to normal load. The clinical presentation may sometimes resemble late postoperative infection.
Similar content being viewed by others
References
Brookes DB, Burstein AH, Frankel UH (1970) The biomechanics of torsional stress fractures, the stress concentrations of a drill hole. J Bone Joint Surg [Am] 52:507–512
Devas M (1975) Stress fractures. Churchill Livingstone, Edinburgh, p 2
Pilliar R, Cameron H, Binnington A, Szivek J (1979) Bone ingrowth and stress shielding with a porous surface coated fracture fixation plate. J Biomed Mater Res 13:799–810
Sand M, Sartoris D, Resnick D (1989) Diagnostic imaging of tarsal and metatarsal stress fractures. Orthop Rev 18:178–185
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Velkes, S., Nerubay, J. & Lokiec, F. Stress fracture of the proximal femur after screw removal. Arch Orthop Trauma Surg 115, 61–62 (1996). https://doi.org/10.1007/BF00453221
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00453221