Bilateral Femoral Neck Stress Fracture in an Obese Middle-Aged Female With Osteomalacia and Coxa-Vara Managed by Simultaneous Bilateral Total Hip Arthroplasty

Femoral neck stress fractures in middle-aged individuals are usually associated with underlying metabolic bone disease. There is increased abnormal loading on femoral neck with associated coxa-vara and obesity in a female. Bilateral presentation of such fractures is rarely reported. Their management poses significant challenges. We present a case of bilateral femoral neck stress fracture in a 58-year-old obese housewife with compression type of the left hip fracture and tension type of the right hip fracture with non-union following an operated femoral neck stress fracture. She presented two months from the onset of symptoms and was treated with simultaneous bilateral total hip replacement for the management of her painful hips. Follow-up at 18 months revealed excellent outcome and return to independent painless daily routine activity. This report highlights the importance of early recognition of femoral neck stress fracture and challenges in the management of their late presentation. Total hip arthroplasty allows early mobilization with a favorable functional outcome.