Correlation between Abnormal Gait Pattern With Femoral Neck Stress Fracture In Athletes: A Systematic Review
Authors: Faza Agya Ghilman , Nurfadhilah Muhammad Iqbal 
Published: February 2023

Backgrounds:

Stress fractures are common overuse injuries in the lower extremities. Repetitive episodes of high-intensity or extended-duration axial load to the leg place the bone at risk of stress-related injury. The femoral neck is an uncommon location for stress fracture (less than 5% of all stress fractures). Fracture location, type, and grade permits generic dichotomized classification of “low-risk” and “high-risk” fractures. Tension-side femoral neck stress fractures are considered “high-risk” because of their potential for displacement, nonunion, and avascular necrosis if displaced. Fractures in locations prone to these 3 outcomes are categorized as “high risk.” These include anterior tibial cortex, medial malleolus, talar neck, dorsal tarsal navicular, proximal fifth metatarsal metaphysis, tension side patella, and tension side of the femoral neck. The risk of avascular necrosis following treatment of displaced femoral neck fractures in adults may be as high as 45%. In runners, pain typically begins with onset of weight bearing early in the run. Pain may progressively increase and does not remit until the run ends. In some athletes, the desire to train or perform may supersede the pain. This may lead to disastrous consequences if a femoral neck stress fracture completes itself and displaces. This paper describes side effects abnormal gait pattern to femoral neck stress fractures in athlete.

Methods:

Our trial was an international, expertise-based, randomized, controlled trial. Details of the trial objectives and design have been published previously. Additional information about the eligibility criteria, interventions, follow-up, outcome definitions, and statistical analysis. To identify studies pertaining to the clinical results about Correlation between Abnormal Running Gait Pattern and Femoral Neck Stress Fracture, we reviewed the Cochrane, Pubmed, Embase databases for relevant articles published up to July 2022. We also reviewed the references of all identified articles to identify additional studies. Search terms were as follows: femoral neck stress fracture, femoral fracture, running gait. Following the PICOS (Participants, Interventions, Comparisons, Outcomes and Study design) principle, the key search terms included (P) patients were runner with FNSFs; (I) patients were running as a recreational sport, and or professional athlete; (C/O) the outcomes including sign and symptoms, femoral neck stress fracture, length of rehabilitation, time to get back in early performance in sport; (S) RTC, cohort study, or case control study.

Results:

A total of 13 RCTs, meta- analysis and systematic review correlation abnormal running gait with femoral neck stress fractures. Discussions: There are correlations between abnormal running gait with femoral neck fractures, because abnormal running gait with high intense could make bone stress injury. However, bone stress injury at neck femoral is one of many factors that commonly happen become a femoral neck stress fractures.

Conclusions:

Abnormal running gait combining with high intense training are etiology of bone stress injuries in athletes. Bone stress injuries in femoral neck could possibly become femoral neck stress fractures.