A stress fracture of the medial cortex of the femoral neck (tension-side) in a 19-year-old military recruit is detected on MRI. The MOST appropriate management is:
- A Cancellous lag screw fixation urgently ✓
- B Non-weight-bearing with serial X-rays
- C Protected weight-bearing with analgesia
- D Hip spica cast for 6 weeks
Correct answer: A. Cancellous lag screw fixation urgently
Explanation
Femoral neck stress fractures on the tension side (superior-medial cortex) are high-risk fractures prone to displacement and avascular necrosis. Current guidelines recommend urgent internal fixation with cancellous lag screws to prevent completion and displacement, rather than conservative management. Compression-side stress fractures (inferior cortex) can be managed non-operatively with protected weight-bearing. Delay in fixation of tension-side fractures is associated with femoral neck non-union and osteonecrosis.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.