BACKGROUND:The repair method of femoral neck fractures included internal fixation and hip arthroplasty. The selection of repair methods is affected by many factors, such as age, condition of patients, and own physical condition. The selection of repair methods for femoral neck fractures is always controversial. OBJECTIVE:To compare the hip function and prognosis of elderly patients with femoral neck fractures after total hip arthroplasty and hol ow screw fixation. METHODS:140 patients aged less than 60 years, who accepted treatment in Rizhao Hospital of Traditional Chinese Medicine from April 2012 to February 2014, were selected. They were randomly divided into replacement group and fixation group (n=70). Patients in the replacement group received total hip arthroplasty, and patients in the fixation group received hol ow compression screw fixation. Harris score of the hip, complications and satisfactions of the hip were observed, compared and analyzed between the two groups at 1 month post surgery. RESULTS AND CONCLUSION:The excel ent and good rate of Harris score at 1 month post surgery was significantly higher in the replacement group (90%) than in the fixation group (63%) (P<0.05). The incidence of complications was significantly lower in the replacement group (6%) than in the fixation group (29%) (P<0.05). The satisfaction was significantly higher in the replacement group (93%) than in the fixation group (79%) (P<0.05). These results verify that the application of total hip arthroplasty for middle-aged and elder patients with femoral neck fracture has a rapid recovery on joint function, has fewer complications, and is suitable for patients who pursue high-quality survival activities. Cannulated compression screw fixation is suitable for middle-aged and elder patients with good quality of preoperative bone.%背景：股骨颈骨折的修复方法包括内固定和髋关节置换，患者修复方法的选择受多种因素影响，包括年龄、病情、自身身体情况等。股骨颈骨折修复方法的选择一直存在争议。 目的：对比中老年股骨颈骨折患者行全髋关节置换与空心螺钉置入内固定治疗后的髋关节功能及预后。 方法：选取2012年4月至2014年2月日照市中医医院收治的140例股骨颈骨折患者，年龄小于60岁，随机分为置换组和内固定组，每组70例。置换组采用全髋关节置换治疗，内固定组患者采取空心加压螺钉置入内固定治疗。观察两组患者治疗后1个月的髋关节功能Harris评分、并发症发生情况及关节功能满意度，并进行对比分析。 结果与结论：治疗后1个月，置换组Harris评分的优良率为90%，明显高于内固定组63%，差异有显著性意义(P<0.05)；置换组并发症发生率为6%，明显低于内固定组29%，差异有显著性意义(P<0.05)。置换组患者满意度为93%，明显高于内固定组满意度79%，差异有显著性意义(P <0.05)。提示全髋关节置换对于中老年股骨颈骨折患者来说，关节功能恢复得更快，并发症较少，适合于追求高生存活动质量的患者；而空心加压螺钉置入内固定适用于术前骨质量较好的中年及老年患者。
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