Bilateral stress fractures of the femoral neck complicated by unilateral displacement in a child.

Stress fractures of the femoral neck with an open capital femoral epiphysis in children are very rare. Up to the time of this writing, 12 cases have been described in children between the ages of 5 and 16 years (2, 4, 10-12, 14). The differential diagnosis from other hip diseases causing pain, a limp, and limited movement can be difficult when standard radiographs are normal. In this situation, tomography, isotope bone scanning, and magnetic resonance imaging (MRI) have proved to be very useful in both adults and children (2, 3, 5-8, 10-12). Complications such as nonunion or severe displacement are uncommon in children and have occurred only after they have resumed or continued the causal activity (12). As far as we are aware, bilateral development of a fatigue fracture of the femoral neck in a child has never been reported. We describe the case of an 8-year-old girl who sustained first a right then later a left femoral neck stress fracture. Displacement of the left fracture occurred after a minor but significant injury and required surgical treatment.