Bilateral femoral neck fractures, albeit rare, have been reported in patients with metabolic derangements like chronic kidney disease, and seizure disorders. Abnormal bone quality is a potential risk factor [2,5-7]. High velocity trauma is another because which has been infrequently reported. This may be associated with upper limb injuries, femoral shaft fractures, hip dislocations and pelvic injuries (2, 8, 9). One case due to assault has been reported in a 64 year-old prisoner [3].

To the best of our knowledge, a comparable clinical presentation in a young male subsequent to an assault hasn’t been reported in the existing literature. We propose a distinctive trauma mechanism involving hyper-abduction with variable degrees of external rotation, leading to the observed fracture morphology. The bilateral posterior-superior cortical comminution in the femoral neck may serve as a distinctive indicator for the aforementioned trauma mechanism. Given the patient's youth, osteosynthesis was deemed the preferred treatment. For the relatively undisplaced right side, a minimally invasive percutaneous fixation was chosen. A Single-stage bilateral fixation was performed to expedite early mobilization.

The potential cause for the nonunion on the left side may be attributed to the initial degree of fracture displacement. The requirement of an open reduction also resulted in the loss of the fracture hematoma and its associated growth factors. In contrast to the approach taken by Alzarhani et al [10], who opted for total hip arthroplasty in a similar case of non-union, we chose to address our situation by revising the fixation construct using an angled blade plate and incorporating bone grafting. Our decision was influenced by the patient's young age. For elderly individuals, arthroplasty is the preferred treatment and can be conducted in a single stage [11-13].