BACKGROUND
Femoral neck fractures are prone to nonunion due to compromised vascular supply. While surgical revision remains the standard of care, biological approaches such as platelet-rich plasma (PRP), a concentrate rich in growth factors that enhance bone healing, offer a less invasive option. This report describes the case of a 44-year-old man, who worked as a manual laborer, with a femoral neck fracture nonunion who refused further surgery and was treated with ultrasound-guided percutaneous injections of PRP.
CASE REPORT
Nine months after undergoing internal fixation for a complex hip fracture, a 44-year-old man presented with persistent right hip pain and gait impairment. Radiographic evaluation confirmed the diagnosis of an oligotrophic nonunion of the femoral neck. The patient declined surgical revision, and a nonsurgical biological intervention was pursued. This consisted of 3 ultrasound-guided percutaneous injections of autologous PRP administered at 1- to 2-week intervals, followed by a structured, phased rehabilitation protocol. Over the ensuing 7 months, serial radiographic follow-up demonstrated progressive bony union. The treatment resulted in complete resolution of pain at rest, minimal pain on weight-bearing, and a successful return to unassisted walking and light work. No adverse events were reported.
CONCLUSIONS
This case demonstrates that a series of ultrasound-guided percutaneous PRP injections can serve as a successful, minimally invasive, non‑surgical alternative for promoting union in selected cases of femoral neck nonunion, potentially allowing patients to avoid revision surgery.

Keywords: Case Reports; Femoral Neck Fractures; Fracture Healing; Orthopedics; Platelet-Rich Plasma; Ultrasonography