Pediatric hip fractures are rare. This type of injury often requires surgery within 24 hours to prevent complications such as avascular necrosis, bone non-union, and premature physeal closure. Moreover, chronic disuse from untreated fracture causes severe osteopenia. Untreated pediatric hip fracture is uncommon in the developing world due to access to surgical care. Here, we report a pediatric patient who traveled from Honduras with untreated right femoral neck fracture. The delay in her initial surgical intervention left her with chronic non-union of her right hip joint and significant osteopenia of her right leg secondary to chronic disuse. This patient required a total right hip arthroplasty rather than the conventional internal fixation. It is crucial for emergency physicians to identify the causes of pediatric hip pain. Early detection of these pathologies allows for early orthopedics involvement and surgical intervention to avoid long-term complications.TopicsPediatric orthopedic, femoral neck fracture, osteopenia.