Background: Femoral neck stress fracture (FNSF) is considered rare, and, as a consequence, is easily misdiagnosed due to a lack of awareness. The initial presentation can be subtle, but serious sequelae, including avascular necrosis of the femoral head or non-union could occur without proper management.

Case Report: A left FNSF in a regularly exercising postmenopausal woman treated by in situ fixation with multiple cannulated screws is presented. Dual energy X-ray absorptiometry (DXA) scan revealed osteopenic bone marrow density (BMD) T-score. Subcutaneous denosumab injection was prescribed immediately following the operation according to World Health Organization (WHO) recommendation. Successful radiographic union was observed after three months without complications, and the patient was able to return to sports activities after six months.

Conclusion: An early and accurate diagnosis of FNSF is essential in returning to sport and preventing undesirable harmful consequences.

Keywords: Femoral neck, Stress fracture, Exercise, Athlete, Osteoporosis

DOI: doi.org/10.35755/jmedassocthai.2020.09.11094

Received 27 February 2020 | Revised 20 May 2020 | Accepted 21 May 2020