Management of displaced intracapsular femoral neck fracture in young adult: why complications are still so high? Case report of posttraumatic avascular necrosis in a 30-year-old man and a brief review

A careful and anatomic or slightly valgus reduction, followed by stable fixation is mandatory for the correct treatment of displaced femoral neck fracture in young adult. Although the management of these fractures has become standard in young patients, the rate of complications continues to be unacceptably high. The incidence of nonunion and osteonecrosis after intracapsular femoral neck fracture has been well documented. Although for the former, a decreasing occurrence has been registered by paying particular attention to the accuracy of the reduction, the incidence of avascular necrosis (AVN) of the femoral head still remain the same as in the 1930s. Complications such as AVN and osteoarthritis can be physically, socially, and economically devastating to these young patients. We report a case of a young man who developed AVN even though every possible indication in the management of his fracture has been followed. We also perform a brief review of the current knowledge on the treatment of this type of fracture.