Femoral neck fractures should be alerted in middle-aged and elderly falls. It is important to come to the hospital in a timely manner to avoid delaying the condition of a fall in middle-aged or elderly people. Fracture of the neck of the femur is a common type of fracture in middle-aged and elderly people after a fall. The latest treatment methods used have restored the activities of many patients. Overview】 Femoral neck fractures often occur in the elderly, and their incidence is increasing day by day as people live longer. The two main problems in its clinical treatment are fracture non-union and ischemic necrosis of the femoral head. Diagnosis】 A history of obvious trauma, pain in the affected limb, and limitation of movement. Х radiographs can determine the fracture site and displacement. Classification】 Pauwells angle: The angle formed between the distal fracture line and the two iliac crests in femoral neck fracture. The larger the pauwel angle, the greater the shear force and the more unstable the fracture. It can be divided into: ① Type I (abductor type) <30°; ② Type II, 30° to 50°; ③ Type III (adductor type) >50° [Treatment measures] (1) Timing of treatment: Early treatment is beneficial to restore post-fracture vascular compression or spasm as soon as possible. In principle, surgery for femoral neck fracture should not exceed 2 weeks. (2) Fracture repositioning: accurate and good repositioning is an important condition for bone healing. Traction is applied to the affected limb, while counter-traction is added to the root of the thigh, and after the original length of the limb is restored, internal rotation and abduction are performed. (3) internal fixation equipment is currently four types of internal fixation equipment: ① single nail class: three-wing nail as the representative, three-blade nail internal fixation for the familiar traditional treatment. This single nail in the mechanical performance of the bone can not last, in addition, this nail is also not suitable for adolescents and neck comminuted fracture. ②Multiple nail fixation: including Schiff’s pin, triangular pin and multiple threaded nails. This type of fixation is less damaging to the bone and takes advantage of the layout of multiple nails in biomechanics for better efficacy, with the disadvantage that the bone does not heal after nail withdrawal. The disadvantage is that the bone does not heal after nail withdrawal. ③ Sliding nail plate fixation device: The advantage of this kind of internal fixation device is that it can make the fracture fragment firmly embedded and help in early weight bearing. However, the operation is difficult and surgical trauma is great. ④Pressure internal fixation: the internal fixation nails are threaded, such as crossed screws, threaded bone round pins and spring-loaded compression screws. (4) Treatment choice: The treatment of fresh femoral neck fracture is mainly based on the fracture site. (1) Fracture of the base of the femoral neck: incomplete fracture and abductor insertion fracture, skin traction or bone traction can be used. ②Mid femoral neck fracture: single nail, multiple pins or compression internal fixation is feasible. ③Subtrochanteric fractures: these fractures are difficult to heal and necrosis often occurs, and artificial joint replacement is often performed in elderly people over 65 years old. For those under this age, multiple pins or internal fixation with compression nails are preferred. Fractures of the femoral neck in children: The main blood supply to the femoral neck in children comes from the intramedullary artery. With four 2mm Kirschner pins, percutaneous penetration of the pins for internal fixation, there is less damage, and the hip is fixed in a herringbone cast for 12 weeks after surgery. The femoral head was closely monitored for the occurrence of femoral head necrosis. (5) Femoral squared tip bone flap graft: tibial tuberosity bone traction for 1 week before surgery to release the contracted periprosthetic muscles and correct the fracture displacement. The femoral neck and femoral head are surgically exposed, the fracture is repositioned, a bone groove is cut along the long axis of the femoral neck, and the bone flap with femorotibial tuberosity is inserted into the groove of the femoral neck, and a compression nail or multiple pins are inserted on the lateral side of the femur below the greater trochanter under direct vision for fixation. (6) Iliac flap transposition graft with a rotated deep iliac vascular tip for femoral neck fracture: can be used for fresh femoral neck fractures in young adults. The femoral artery is surgically exposed and the deep iliac vessels are sought directly under the inguinal ligament. With this vascular bundle as the center, a (5)0 cm × 1.5 cm × 1.5 cm full bone block is designed and wrapped with saline gauze to be used. Artificial femoral head replacement: For those who are over 65 to 70 years old with fresh femoral neck under the head or comminuted fracture with displacement, old fracture not healing or femoral head has necrosis without osteoarthritis in the acetabulum, artificial femoral head replacement surgery is feasible.