A Rare Case of High-Flow Intraosseous Femoral Arteriovenous Malformation Presenting with Pathological Femoral Neck Fracture: Staged Embolization Followed by Hip Arthroplasty

Abstract Intraosseous arteriovenous malformations (AVMs) are uncommon and can occur as isolated bony or mixed bone and soft tissue malformations. They cause bone erosions/resorption due to the shunt effect and weakening, leading to fracture with trivial trauma. They are evaluated using computed tomography/magnetic resonance imaging and angiography to decide on the embolic agent for optimal success. We present an 18-year-old male who presented with femoral fracture after a fall and was subsequently found to have diffuse intraosseous and adjacent soft tissue AVM. He was managed with embolization in three sessions using coils, n-butyl cyanoacrylate, and polyvinyl alcohol particles and underwent total hip replacement.