[Abstract] Objective: To investigate the effects of open reduction and internal fixation with with hollow screw through direct anterior approach (DAA) on operative parameters, fracture healing time and total weight-bearing time of femoral neck patients. Methods: The clinical data of 58 patients with femoral neck fracture treated in our hospital from July 2014 to June 2015 were analyzed retrospectively, among them, 32 patients who underwent open reduction and internal fixation with hollow screw through DAA were in the experimental group, 32 patients who underwent closed reduction and internal fixation with three full-thread hollow screw were performed in 26 cases as control group. Harris hip score was used to evaluate the recovery of hip function after operation, Garden method was used to evaluate the quality of fracture reduction, the healing time and full weight-bearing time of the two groups were compared. Results: Compared with the control group, the Harris score and Garden reduction index in the experimental group increased significantly, and the number of cases of avascular necrosis of femoral head and the number of non-union of fracture in the experimental group were significantly reduced (P < 0.05); compared with the control group, the healing time of fracture in the experimental group was shorter (P < 0.05); compared with the control group, the total weight-bearing time of the experimental group was shorter (P < 0.05). Conclusion: Open reduction and internal fixation with hollow screw via DAA approach is better than that closed reduction and three full-thread hollow screw internal fixation for femoral neck fracture in young adults.