What is the role of surgery in the treatment of hip stress fractures?

Updated: Jan 08, 2019
  • Author: Naveenpal S Bhatti, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Answer

If a significant compression stress fracture is initially apparent on the x-ray film, a more aggressive treatment plan must be initiated because of the tendency for fracture displacement and its associated complications. Closed reduction and internal fixation is recommended. Postoperatively, these patients are allowed to return to athletic activity once fracture healing and remodeling are complete, which may require up to 12 months. The internal fixation devices may be removed 12-18 months after surgery. An additional period of 6 weeks of protected activity is recommended to allow restoration of bone strength, before engaging in excessive athletic conditioning and activity.

Those patients who have sustained a tension-type stress fracture of the femoral neck require surgical stabilization because of the high prevalence of displacement. Following fixation, a standard progressive rehabilitation protocol is recommended. Protected touch-down weight-bearing ambulation with crutches is initiated postoperatively for 6 weeks, under the supervision of a physical therapist. Hardware may be removed 12-18 months following surgery.


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