Am J Orthop. 2008 Jun;37(6):319-22. Graves RM, Sands KC. Avascular necrosis (AVN) of the femoral head is a well-documented complication of intramedullary nailing (IMN) of femoral shaft fractures in adolescents and children (age range, 10 years to 13 years 10 months). In adults, AVN after IMN has been reported in association with femoral neck fractures, intra-articular hip injuries, steroid use, and various other medical conditions. With those factors set aside, the literature includes only 1 case of AVN after IMN in an adult. Now we report the case of a previously healthy, skeletally mature young adult male who, at age 16 years 0 month, was treated with IMN after a traumatic femoral shaft fracture and subsequently developed AVN of the femoral head.