Can hip fracture cause avascular necrosis of the hip?

This concern is particularly relevant when a fracture occurs near the femoral neck, where small blood vessels supply the ball of the hip joint. The risk depends on the fracture pattern, displacement, blood-vessel injury, and treatment circumstances.

Avascular necrosis, also called osteonecrosis, develops when bone tissue loses an adequate blood supply. After a hip fracture, reduced circulation can damage part of the femoral head. The weakened bone may later lose its smooth, rounded shape, affecting how the joint moves and bears weight.

Symptoms may not begin immediately. New or increasing groin, buttock, or thigh pain; stiffness; a limp; or pain when standing can prompt reassessment. These symptoms have several possible causes after a fracture, so examination and imaging are used to distinguish avascular necrosis from healing pain, arthritis, or a problem with fixation.

Keep the follow-up appointments arranged by your orthopaedic team, even if recovery initially feels steady. Report pain that returns, becomes deeper in the groin, or increasingly limits walking. Your clinician may compare examinations and imaging over time because early changes are not always visible on an initial X-ray.

Follow your prescribed weight-bearing limits and rehabilitation plan. Do not increase walking load or stop using crutches solely because pain has eased; progression should reflect fracture healing and the stability of any surgical repair. Treatment for confirmed avascular necrosis is tailored to the amount of bone affected, joint shape, symptoms, mobility needs, and previous fracture treatment.

Contact your orthopaedic service promptly for worsening hip or groin pain, a new limp, reduced ability to bear weight, or a noticeable loss of movement after a period of improvement. Seek urgent assessment after a new fall, sudden severe pain, inability to stand, a visibly shortened or turned leg, wound drainage, spreading redness, fever, or new numbness or weakness in the leg.

Ask where the fracture lies in relation to the femoral-head blood supply, whether it was displaced, what symptoms should trigger earlier review, and when repeat imaging is planned. Also clarify your current weight-bearing limit, which rehabilitation exercises are appropriate, and how the treatment plan would change if the femoral head showed signs of osteonecrosis.