Enhanced Stability in an Unstable Femoral Neck Fracture Using the Femoral Neck System with Two Additional Cannulated Cancellous Screws: A Case Report

Introduction: Femoral neck fractures in young adults require urgent anatomical reduction and stable fixation to preserve the native femoral head and prevent complications, such as avascular necrosis and non-union. The femoral neck system (FNS) provides angular stability, but its effectiveness may be limited in vertically orientated unstable fractures. Case Report: We report a case of a 42-year-old male with a Pauwels type III femoral neck fracture managed using a hybrid construct consisting of the FNS augmented with two additional cannulated cancellous screws. The patient underwent surgery within 15 h of injury following pre-anaesthetic evaluation. Anatomical reduction and stable fixation were achieved. Progressive fracture healing was observed with complete union at 3 months and an excellent functional outcome. Conclusion: Augmenting the FNS with additional cannulated cancellous screws enhances rotational stability and may improve outcomes in unstable vertical femoral neck fractures. Keywords: Femoral neck fracture, femoral neck system, cannulated cancellous screws, Pauwels type III, augmented fixation.