Femoral neck stress fractures and metabolic bone disease

Objective: To determine whether metabolic bone disease plays a role in the cause of femoral neck stress fractures. Study Design: Twenty-three patients with femoral neck stress fractures were enrolled prospectively in the study. Examination included computed tomogra phy bone densitometry, trace mineral analysis, and histomorphometric analys is of the iliac crest in thirteen patients who underwent surgical treatment of their stress fractures. A control group of fifteen patients undergoing iliac crest bone grafting for scaphoid nonunions underwent similar examinat ions. Setting: Tertiary military medical center. Results: Patients with femoral neck stress fractures had lower bone mineral density than did control patients (p = 0.010), but no trace mineral defici encies or consistent histomorphometric differences were noted. Conclusions: Bone mineral density is decreased in patients with femoral nec k stress fractures. Despite observations of decreased bone mineral density in the stress fracture group, osteoporosis, as determined by histomorphomet ry, is not a consistent Ending.