Objective: This study is to evaluate the clinical and radiological outcome of unstable fracture neck of the femur in young adults treated with three cannulated cancellous screws augmented with medial buttress plate. Materials and methods: Fifteen patients of less than 60 years were operated from January 2017 to March 2018. Reduction was achieved by closed or open means to Garden's alignment index grade I. Internal fixation was done with three cannulated cancellous screws through mini lateral incision, and medial buttress plating was done through modified Smith–Peterson approach. All patients were mobilized from the immediate postoperative period and allowed toe-touch weight-bearing as tolerated. All patients were followed at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months postoperatively. Results: Fracture united in 14 of 15 patients. Reduction loss and backing out of cancellous screws occurred in one patient. No cases of avascular necrosis was identified at a mean follow-up of 13.7 months. No significant femoral neck shortening was observed in all united fractures. Conclusion: Anatomical reduction by closed or open method; stable fixation with three cannulated cancellous screws augmented with medial buttress plate, increases fracture union rate compared to the historical series using closed reduction and cancellous screw fixation alone. Open reduction and medial antiglide plate fixation do not appear to increase morbidity.