Mejía  Luz A,Montoya  Beatriz E,Victoria Eugenia Restrepo Noriega,
Pathological Fracture of Femoral Neck Associated to Femoral Head Osteonecrosis: Case Report
Surgery Case Reports
2019
2733-225X
http://dx.doi.org/10.31487/j.JSCR.2019.01.05
https://www.sciencerepository.org/pathological-fracture-of-femoral-neck-associated-to-femoral-head-osteonecrosis_JSCR-2019-1-105 
Abstract: Introduction: The osteonecrosis of femoral head is a progressive and devastating condition for the
prognosis of the coxofemoral joint, with an increase in its prevalence and an etiology of multifactorial
nature, and with compromise specially in young or middle age (20 to 40 years of age) patients [1-3]. The
fractures associated to femoral head osteonecrosis are very rare, being the subchondral portion the site with
a higher compromise, and the junction between the necrotic bone and the bone under remodeling process
another site of potential fracture [4-7]. The management of this condition can vary from a conservative
management to a surgical management with total hip arthroplasty, depending on patient’s clinic and the
extension of his necrotic lesion.
Discussion: This patient presents a sub-capital fracture of his femoral neck, associated to osteonecrosis of
the femoral head. This patient was managed with decompression of the osteonecrosis nucleus plus bone
graft and osteosynthesis with cannulate screws, in order to decrease bone hypertension and avoid femoral
collapse.
Conclusion: Although femoral neck fractures, as a complication from femoral head osteonecrosis are rare,
in our patient such association can be found due to the worsening of his painful clinical features and the
absence of a previous traumatic event, which allows discarding femoral osteonecrosis as a fracture
complication.Keywords: Osteonecrosis, femoral head, spontaneous fractures, fracture internal fixation, complication