Abstract: Objective To observe the clinical effect of internal fixation with hollow compression screw for old patients with femoral neck fracture.Methods 102 old patients with femoral neck fracture were randomly classified into two groups,which observation group with 57 cases were treated with internal fixation with hollow compression screw and control group with 45 cases were treated with total hip replacement.The clinical effect between the two groups were compared.Results The effective rate in observation group was significantly higher than that in control group(x2=4.33,P<0.05).There was no significant difference in avascular necrosis between the two groups(x2=1.91,P>0.05).Conclusion Internal fixation with hollow compression Screw for old patients with femoral neck fracture Was safe and can improve clinical effect,which could be applied in clinic.