Fractures of the neck of the femur occur in the elderly population and are more common in women. The cause of fractures is usually due to indirect violence of twisting of the hip in an inadvertent fall. The pathophysiological basis of femoral neck fractures is age-related osteoporosis, and therefore they are less likely to occur in the young adult population. If they do occur, they are most often caused by high-energy major trauma such as car accidents and falls from a height. Treatment of femoral neck fractures is generally divided into conservative treatment, internal fixation and artificial joint replacement. Conservative treatment is suitable for patients with incomplete fractures without displacement, or whose general condition is not suitable for surgery; internal fixation is suitable for almost all young and middle-aged people, as well as for older people with insignificant fracture displacement, high activity, and younger people; artificial joint surgery is mainly suitable for elderly patients with significant fracture displacement and unsatisfactory repositioning, and all elderly patients. The following are a few aspects that need to be noted in clinical treatment: 1. For young and middle-aged patients, the treatment principle is to fix the fracture internally as much as possible and avoid joint replacement surgery as much as possible. Even if the position of the fracture is still unsatisfactory after closed reduction, do not easily do joint replacement, but consider doing incisional internal fixation surgery. This is because the young population is very active and the “use value” of their hip joint is much greater than that of the elderly, so the patient should be given a chance to hope that the femoral neck fracture will heal anyway. Once an arthroplasty is done, there is only one revision surgery that can be done later, and probably more than once. Of course, some patients with internal fixation surgery may suffer ischemic necrosis of the femoral head in the future, in which case they will have to undergo joint replacement again. As for the method of internal fixation surgery, there are many different methods, and nowadays, cancellous bone hollow tension screws are generally used for internal fixation. Three screws are generally required, and two are strongly discouraged. The technique of internal fixation is also very delicate, including the fixation position of the screws, the arrangement of the screws with each other, etc.. The surgical techniques involved are specialized and I will not go into them here. In short, these factors are closely related to the success of the operation. 2, older elderly patients, even if the fracture is not significantly displaced or even stable insertion, it is not recommended to do internal fixation surgery, this is because after the internal fixation surgery patients must not be able to walk with weight for at least three months, long-term bed rest for the elderly is likely to cause complications such as pneumonia, bed sores, urinary sensation. Another reason is that elderly patients generally have more pronounced osteoporosis, which makes it easier for internal fixation to fail and for the fracture to heal. There is no problem of fracture healing with direct artificial joint replacement surgery, so it is beneficial to the rapid recovery of the patient’s postoperative function and reduce postoperative complications. 3, for patients who do artificial hip replacement, there are two general options, one is to do half hip replacement, such as unipolar or bipolar artificial femoral head replacement; the second is to do total hip replacement. Generally speaking, total hip is suitable for older patients who are physically fit and active and younger, such as those under 65 years old. The hemi-hip is suitable for older patients who are in poor health and less active, such as those over 70 years old. For elderly patients who cannot tolerate surgery well, hemi hip replacement is recommended, which can significantly shorten the operation time, reduce bleeding and surgical trauma, reduce all kinds of postoperative complications, and speed up the functional recovery after surgery.