Skip to main content


Log in

Insufficiency fractures of both femoral necks in a young adult caused by osteoporosis: a case report

  • Osteoporotic Fracture Management
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript


Insufficiency fractures of femoral necks due to osteoporosis of unknown aetiology occurring coincidentally on both sides in young adults, have not been described in English literature so far. A 18-year-old young girl presented with a 3-month history of gradual onset of bilateral thigh pain and progressive inability to walk. At the first look, plain radiographs of both hips showed no gross abnormal findings other than some tips on reduced bone mineral density of the femoral necks. MRI was ordered upon a high suspicion of fracture and T1-weighed MRI showed a linear low signal on both femoral necks. Dual-energy X-ray absorptiometry of the lumbar spine and femoral neck showed low mineral density. She was treated surgically with in-situ internal fixation using cannulated screws. The bilateral thigh pain was resolved and walking started immediately after the treatment. Insufficiency fracture of the femoral neck due to osteoporosis should be kept in mind even in young adults complaining of atypical pain without evidence of unusual activities. We used both the terms of stress fracture and insufficiency (osteoporotic) fracture interchangeably as the mechanism of fractures resemble each other.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others


  1. Bennell KL, Brukner PD (1997) Epidemiology and site specificity of stress fractures. Clin Sports Med 16:179–196

    Article  PubMed  CAS  Google Scholar 

  2. Brudvig TJ, Gudger TD, Obermeyer L (1983) Stress fractures in 295 trainees: a one-year study of incidence as related to age, sex, and race. Mil Med 148:666–667

    PubMed  CAS  Google Scholar 

  3. Devas MB (1965) Stress fractures of the femoral neck. J Bone Joint Surg Br 47:728–738

    PubMed  CAS  Google Scholar 

  4. Egol KA, Koval KJ, Kummer F, Frankel VH (1998) Stress fractures of the femoral neck. Clin Orthop Relat Res 348:72–78

    Article  PubMed  Google Scholar 

  5. Fullerton LR Jr, Snowdy HA (1988) Femoral neck stress fractures. Am J Sports Med 16:365–377

    Article  PubMed  Google Scholar 

  6. Ha KI, Hahn SH, Chung MY, Yang BK, Yi SR (1997) A clinical study of stress fractures in sports activities. Orthopedics 14:1089–1095

    Google Scholar 

  7. Iba K, Wada T, Takada J, Yamashita T (2003) Multiple insufficiency fractures with severe osteoporosis. J Orthop Sci 8:717–720

    Article  PubMed  Google Scholar 

  8. Iwamoto J, Takeda T (2003) Stress fractures in athletes: review of 196 cases. J Orthop Sci 8:273–278

    Article  PubMed  Google Scholar 

  9. Johansson C, Ekenman I, Törnkvist H, Eriksson E (1990) Stress fractures of the femoral neck in athletes, The consequence of a delay in diagnosis. Am J Sports Med 18:524–528

    Article  PubMed  CAS  Google Scholar 

  10. Lafforgue P, Acquaviva PC (1992) Stress fracture in the medial femoral condyle. A case report. Acta Orthop Scand 63:563–565

    Article  PubMed  CAS  Google Scholar 

  11. Maitra RS, Johnson DL (1997) Stress fractures. Clinical history and physical examination. Clin Sports Med 16:259–274

    Article  PubMed  CAS  Google Scholar 

  12. Visuri T, Vara A, Meurman KO (1988) Displaced stress fractures of the femoral neck in young male adults: a report of twelve operative cases. J Trauma 28:1562–1569

    Article  PubMed  CAS  Google Scholar 

  13. Weber M, Hasler P, Gerber H (1993) Insufficiency fractures of the sacrum. Twenty cases and review of the literature. Spine 18:2507–2512

    Article  PubMed  CAS  Google Scholar 

  14. Wild A, Jaeger M, Haak H, Mehdian SH (2002) Sacral insufficiency fracture, an unsuspected cause of low-back pain in elderly women. Arch Orthop Trauma Surg 122:58–60

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Aydıner Kalacı.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kalacı, A., Yanat, A.N., Sevinç, T.T. et al. Insufficiency fractures of both femoral necks in a young adult caused by osteoporosis: a case report. Arch Orthop Trauma Surg 128, 865–868 (2008).

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: