Femoral neck fractures in young patients are usually caused by high-energy trauma. These fractures are often associated with multiple injuries and high rates of avascular necrosis and nonunion. Results of this injury depend on the extent of injury (ie, amount of displacement, amount of comminution, whether circulation has been disturbed), the adequacy of the reduction, and the adequacy of fixation. Recognition of the disabling complications of femoral neck fractures requires meticulous attention to detail in their management.