Femoral Neck Fractures: Surgical Management, Fixation Strategies, and Late Presentations

As part of the SONA Global / Harvard Global Orthopaedics Collaborative educational programme, this module focuses on the surgical management of femoral neck fractures, with particular attention to fracture biology, reduction strategy, implant selection, complications, and the management of late-presenting femoral neck fractures in young patients.

The content includes expert-led educational video material covering the vascular anatomy of the femoral head, displaced versus non-displaced femoral neck fractures, indications for fixation versus arthroplasty, principles of capsulotomy and reduction, fixation constructs, femoral neck–shaft fracture combinations, and decision-making in delayed presentations. Key topics include osteonecrosis risk, nonunion, intracapsular tamponade, implant stability, surgical approaches, and the role of fixed-angle devices in young or late-presenting patients.
The course is designed to provide orthopaedic surgeons and trainees with practical, evidence-based insights into the management of these challenging injuries, including strategies applicable in both well-resourced and resource-limited surgical settings.

*This education video material is provided by SONA Global Academy / Harvard Global Orthopaedics Collaborative. SONA Global Academy empowers healthcare professionals worldwide with high-quality trauma and orthopaedic education. Through expert-led courses and conferences, we inspire learning, innovation, and excellence in surgical care—ensuring everyone, everywhere has access to the best training possible. 

Speakers

• Mark Swiontkowski, MD
• Jack Wickstead, MD

Learning objectives

• Improve participants’ understanding of femoral neck fracture biology, including femoral head blood supply, intracapsular pressure, osteonecrosis risk, and nonunion.
• Strengthen clinical decision-making regarding fixation versus arthroplasty in non-displaced, displaced, elderly, physiologically young, and late-presenting patients.
• Review surgical principles of femoral neck fracture reduction, capsulotomy, implant positioning, and fixation stability.
• Discuss implant selection, including cannulated screws, sliding hip screws, blade plates, counter-rotation screws, and medial buttress plating.
• Recognize common complications after femoral neck fracture treatment, including avascular necrosis, nonunion, fixation failure, subtrochanteric fracture, and need for revision surgery.
• Support orthopaedic surgeons and trainees in applying practical treatment strategies across diverse clinical and resource settings.