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More active individuals are treated with total hip arthroplasty. Less active individuals may receive a hemiarthroplasty. With displaced fractures of the femoral neck in elderly patients, the treatment depends on the patient's baseline activity level and age. However, there a higher rate of avascular necrosis (AVN) with the use of a sliding hip screw (9%) compared to cannulated screws (4%). Non-displaced fractures are treated typically with percutaneous cannulated screws or a sliding hip screw. With displaced fractures in younger patients, the goal is to achieve anatomic reduction through emergent open-reduction internal fixation. A sliding hip screw is biomechanically more stable for these fracture patterns. Vertically oriented fractures such a Pauwel III type fractures are more common in younger and high-energy trauma patients. Young patients with femoral neck fractures will require treatment with emergent open reduction internal fixation. It is only potentially useful for non-ambulatory, comfort care, or extremely high-risk patients. Non-operative management for these fractures is rarely the treatment course. The blood supply of the femoral head is an essential consideration in displaced fractures as it runs along the femoral neck. The junctional location makes the femoral neck prone to fracture. The hip joint is the articulation of the femoral head with the acetabulum. The femoral neck connects the femoral shaft with the femoral head. įemoral neck fractures are a specific type of intracapsular hip fracture. It is estimated there will be approximately 300,000 cases of hip fractures annually in the United States by the year 2030. In the United States, the economic burden of hip fractures is amongst the top 20 expensive diagnoses, with approximately 20 billion dollars spent on the management of this injury. Immediate diagnosis and management are required to prevent threatening joint complications. It is also seen in young patients who perform in athletics or high-energy trauma. Hip fractures are common injuries, especially seen in the elderly in the emergency setting.