【Abstract】0bjective To discuss the clinic effect of treating Garden Ⅲ femoral neck fracture for aged by closed reduction and internal fixation and intraarticular decompression through femoral neck， with treatment-Oriented Approach in interfering and controllable correlation factors which affected prognosis of femoral neck fractue． Methods 251 elder patients with Garden Ⅲ stage of femoral neck fracture from September 2005 to September 2010，who met the inclusion criteria and were treated by closed reduction and internal fixation with cannulated screws，were divided into decompression group and general group by grouping standards whether to intraarticular decompression through femoral neck. Statistical indicators， including fracture union，fracture healing time，femoral head necrosis and the hip function，were analyzed by SPSS21.0 statistic system． Results Following up from 60 to 120 months with average of 68.2 months，Operative incision of all was primary healing and no infection. In decompression group，fracture union rate was 95.1%，average healing time was（8.3±2.1）months，necrosis rate of femoral head was 7.7% and Harris hip joint scores were average out to （90.6±6.5）scores . In general group，they were as follows: 92.7%，（12.7±3.3）months，16.5% and （78.3±9.2）scores。 There was significant difference between two groups in average healing time ，necrosis rate of femoral head and the hip function（P＜0.05）．Conclusion：Intraarticular decompression through femoral neck was minimally invasive and easy to operate， and it may be related to accelerating fracture healing and reducing necrosis rate of femoral head for elderly Garden Ⅲ femoral neck fracture． With treatment-Oriented Approach in interfering and controllable correlation factors which affected prognosis of femoral neck fracture， making the best of controllable favorable factors and positively intervening unfavorable factors，Garden Ⅲ femoral neck fracture in yang elderly can firstly choice internal fixation and intraarticular decompression through femoral neck .