Osteomalacia and coxa vara. An unusual co-existence for femoral neck stress fracture

•Femoral neck stress fractures are not uncommon.•Osteomalacia is a common cause of insufficiency fractures.•Coxa vara is a rare cause of femoral neck stress fractures.•Co-existence of osteomalacia and coxa vara is a rare condition.

IntroductionFemoral neck stress fractures are not uncommon. Several causes exist about these fractures. Osteomalacia is one of the most common cause of insufficiency fractures and coxa vara can produce a focal concentration of mechanical stress in the femoral neck and may cause stress fractures. This case study is about the co-existence of these two pathologies in a patient with bilateral femoral neck stress fracture.Presentation of caseA 26-year-old woman admitted to our department with a complaint of bilateral groin pain and diagnosed as bilateral coxa vara and osteomalacia. Medical treatment for osteomalacia and staged bilateral Pauwels’ osteotomy was performed. After 2 years of follow-up, good result was obtained.DiscussionThere are several risk factors for stress fractures and osteomalacia and coxa vara are two of the causes. Osteomalacia results in softening of the bones and coxa vara can produce a focal concentration of stresses in the femoral neck.ConclusionJoint and bone pain without any trauma should be investigated and bone metabolism disorders should be kept in mind. There might be co-existing factors related with stress fractures, and they must be treated simultaneously.