Elderly femoral neck fractures, especially subtrochanteric and comminuted fractures, are now mostly treated clinically with artificial femoral head replacement due to the high incidence of nonunion and ischemic necrosis of the femoral head. Artificial femoral head replacement is suitable for patients with femoral neck fractures, whether fresh, old or pathological. For older patients and patients with poor physical condition, artificial femoral head replacement should be the first choice of treatment if they can tolerate the surgery after adjustment by medical treatment, so as to avoid complications such as pneumonia and decubitus ulcer due to long-term bed rest. However, for patients with old fractures and those who are less than 65 years old and in good health, it is clinically advisable to perform total hip replacement. The early release of the patient from bed after surgery can prevent osteoporosis and acetabular cartilage degeneration and reduce complications such as osteoporosis and sinking of the prosthesis.