Older people have more lax bones and generally minor trauma, such as landing on the hip, can lead to fractures of the femoral neck and inter-rotor. After the fracture, they cannot stand and need to be bed-bound. However, the elderly cannot stay in bed for a long time because of the decline of organ functions, otherwise they are prone to complications such as pneumonic pneumonia (mainly due to lung infection caused by sputum not easily discharged), decubitus ulcer, urinary tract infection, and deep vein thrombosis of the lower limbs. The choice of treatment for femoral neck and hip fractures in the elderly depends on the patient’s physical health, age, fracture type, degree of displacement, and the quality of the bone. For young patients, even if there is a risk of femoral head necrosis, closed or incisional internal fixation should be the first choice for surgery; while for elderly patients, there are more options available. The principles of treatment for elderly patients are: early surgery and early postoperative bed release. The aim is to effectively prevent complications such as pneumonia, decubitus ulcers, urinary tract infections, and deep vein thrombosis that may occur as a result of prolonged bed rest. There are various treatment methods for femoral neck fractures in the elderly, including closed percutaneous hollow nail internal fixation, single head replacement, bipolar head replacement and total hip replacement. For inter-rotator fractures, power hip (DHS) internal fixation, proximal femoral intramedullary nailing (PFN) internal fixation, and artificial joint replacement can be chosen.