An 18-year-old female army recruit complains of progressive anterior thigh pain during training. MRI shows a femoral neck stress fracture located on the superior (tension) surface of the femoral neck without displacement. The most appropriate management is:
- A Prophylactic internal fixation followed by protected weight bearing ✓
- B Continued activity modification with progressive return to running
- C Core decompression of the femoral head
- D Hip arthroscopy with labral repair
Correct answer: A. Prophylactic internal fixation followed by protected weight bearing
Explanation
Tension-side (superior cortex) femoral neck stress fractures are at high risk of propagation into a complete displaced fracture, with catastrophic consequences including AVN and nonunion even after later fixation. Guidelines recommend prophylactic cancellous screw fixation with protected weight bearing. Compression-side (inferior cortex) incomplete fractures are the subtype that may be managed conservatively with rest and gradual return, which makes option B the classic trap answer.
Reference: Rockwood and Green's Fractures in Adults, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.