Bilateral femoral fatigue fracture: an unusual fracture in a military recruit.

We present a case report of a military recruit who had bilateral fatigue fractures of the distal femur. Possible predisposing factors and the long-term outcome of these unusual stress fractures also are presented. A 19-year-old recruit experienced knee pain 2 weeks after starting his military service. Bilateral nondisplaced transverse fatigue fractures were detected radiographically in the supracondylar region on the right side and in the distal 1/3 of the femoral shaft on the left side. The fractures were treated with plaster casts for 5 weeks and healed properly. Osteopenia was seen in further examinations. At followup after 31 months followup the patient had fully resumed his previous athletic activity level and was symptom-free. Osteopenia still could be detected at the final examination. Nonoperative treatment with careful followup resulted in a favorable outcome in the nondisplaced bilateral distal fatigue femoral fractures in this patient.