Femoral Neck Stress Fractures in South Korean Male Military Recruits.

BACKGROUD: Femoral neck stress fractures (FNSFs) are rare but potentially disabling injuries if the diagnosis is missed or delayed and proper treatment is not provided. The aim of this study was to investigate and describe the characteristics and clinical course of FNSFs in South Korean male military recruits. METHODS: Between May 2015 and October 2019, 16 fractures in 12 young male military recruits were reviewed. The characteristics of the fractures were ascertained by detailed analysis of the history and clinical course, as well as radiographs, bone scintigrams, and magnetic resonance images. RESULTS: The median duration between endurance training and the development of hip pain was 5 weeks, while the median duration of pain before the patient sought medical attention was 3 weeks. Four patients (33.3%) exhibited bilateral fractures, and concomitant lesions involving the proximal tibia were found in 3 patients (25%). Fourteen of the 16 fractures (87.5%) were compression-type fractures, and surgery was performed for 7 hips. Complete union without malunion or osteonecrosis was achieved in all cases, and all cadets returned to their full activity levels in an average of 10 weeks. CONCLUSIONS: We observed excellent prognosis of FNSFs. Our report highlights the importance of early reporting, detection, and treatment regarding the challenging management of FNSFs. When a military recruit reports hip pain, a FNSF should be considered; furthermore, the bilaterality of the fracture and the presence of concomitant lesions should also be investigated.

Trigger thumb in children: results of surgical treatment in children above 5 years of age.

BACKGROUND: There have been debates about the results of surgical treatment in older children, even though many studies showed excellent results in pediatric trigger thumb. The objective of this study was to identify the possible problems or complications related to the delayed surgery for trigger thumb in children. Authors clinically reexamined the patients who had undergone A1 pulley release above the age of 5 years and analyzed the results of surgical treatment. METHODS: A retrospective study of 31 trigger thumbs was performed on 23 consecutive children treated using a standardized surgical technique. The mean age at the operation was 7.46 years and average period of clinical follow-up was 2 years and 3 months. We investigated the presence or absence of interphalangeal joint flexion contracture, triggering, recovery of active range of motion, postoperative period that the patients get more than 0 degree interphalangeal joint extension, and complications. RESULTS: Flexion contracture and painful triggering were successfully relieved after surgery in all cases. Patients showed variable periods in improving temporary extension weakness of interphalangeal joint, but there was no statistical difference in the final result between early and delayed improvement or between symptom duration and healing time. None of these patients had any postoperative complications. CONCLUSIONS: Surgical treatment with A1 pulley release for over 5 years of age resulted in successful resolution of trigger thumb and satisfactory clinical outcome in all our cases regardless the age at the time of surgery. From the author's findings, we can expect satisfactory results of surgical treatment in pediatric trigger thumb even in the case of delayed diagnosis or late treatment.