Abstract:Abstract: [Objective] Comparison of the effectiveness of femoral neck system (FNS) and cannulated screw (CS) in the treatment of femoral neck fractures in young and middle-aged patients. [Methods] A retrospective analysis was conducted of the 137 young and middle-aged patients who had been surgically treated for femoral neck fracture at Honghui Hospital from June 2019 to June 2021.The patients were divided into CS group (73 cases) and FNS group (64 cases). Perioperative conditions, follow-up consequences and imaging data were compared between the two groups. [Results] In the FNS group, operation time, fluoroscopy frequency, postoperative partial weight-bearing time was significantly superior than those in the CS group, and the incision length was significantly longer than CS group (P<0.05); VAS scores in both groups decreased significantly with postoperative time, and VAS scores in the FNS group were significantly lower than those in the CS group at 3, 7, and 30 days postoperatively (P<0.05). There was no significant difference in intraoperative blood loss, auxiliary reduction, wound healing and hospital stay between the 2 groups(P>0.05). The follow-up period lasted for 6 to 21 months. The FNS group lateral thigh irritation (1 ,1.6%) significantly lower than that in the CS group(21cases, 28.8%). Two patients(2.7%)in the CS group underwent total hip arthroplasty due to femoral head necrosis. Harris score and hip mobility increased significantly in both groups with postoperative time, and The FNS group was significantly superior than those in the CCS group at the same time point (P<0.05). With respect to radiographic evaluation, the FNS group fracture healing time was significantly less than that in the CS group. In the last follow-up, femoral neck shortening, neck-shaft angle and internal fixation withdrawal in the FNS group were better than those in the CS group (P<0.05). There were no significant differences in Garden index, neck shortening and neck-shaft angle between the 2 groups in the immediate postoperative period(P>0.05).[Conclusion] FNS can firmly fix the fracture and reduce lateral thigh irritation caused by internal fixation withdrawal. While shortening the postoperative partial weight-bearing time and fracture healing time, it can better maintain the postoperative neck-shaft angle and femoral neck length, which is conducive to the recovery of postoperative hip joint function.