Abstract:[Objective] Comparison of the effectiveness of femoral neck system (FNS) and cannulate compression screw (CCS) in the treatment of femoral neck fractures in young and middle-aged patients.[Methods] A retrospective analysis of 94 patients with femoral neck fractures who met the selection criteria from November 2019 to June 2020 was divided into FNS group (46 cases) and CCS group (48 cases) according to doctor-patient communication. The perioperative period, follow-up and imaging results were compared between the two groups. [Results] Both groups completed the operation successfully, and there were no serious complications such as neurovascular injury during the operation. The average follow-up time was 15.48±1.62 months. In the perioperative period, the operation time, intraoperative blood loss, intraoperative fluoroscopy times and hospital stay in the FNS group were all less than those in the CCS group. The follow-up results showed that the full weight-bearing walking time in the FNS group was significantly earlier than that in the CCS group (P<0.05). Harris score, hip extension-flexion ROM, hip internal-external rotation ROM increased significantly with recovery time in both groups.VAS score pain gradually decreased with time. Harris score and VAS score in FNS group were lower than CCS 1 month after operation. Imaging results Garden alignment index, fracture union and Tonnis grade showed good fracture healing in both groups. Femoral neck shortening and the internal fixation stability of the FNS group was significantly less than the CCS group. [Conclusion] FNS surgery was less traumatic, more stable, and better hip function after surgery compared with traditional internal fixation.