Abstract:Objective To compare the curative effect of internal fixation with femoral neck system(FNS） and cannulated compression screw（CCS） in patients with Pauwels Ⅱ and Ⅲ femoral neck fractures. Methods The clinical data of 64 patients with Pauwels Ⅱ and Ⅲ femoral neck fractures aged 18-65 years who were admitted to Qinghai Provincial People's Hospital from January 2020 to December 2021 were retrospectively analyzed. Twenty-nine cases using FNS for internal fixation treatment were in FNS group, and 35 cases using CCS were in CCS group. The hospitalization time, operation time, intraoperative blood loss, the number of intraoperative X-ray fluoroscopy, postoperative weight-bearing time, fracture healing time, Harris Hip Score and the occurrence of complications were compared between two groups. Results There was no significant difference on the general data and hospitalization time and operation time between two groups (P>0.05). The intraoperative blood loss in FNS group was higher than that in CCS group, while the number of intraoperative X-ray fluoroscopy, postoperative weight-bearing time and fracture healing time were less than those in CCS group, with statistical significance (P＜0.05). At the last follow-up, there was no significant difference in Harris Hip Score between two groups (P>0.05). The incisions healed well in both groups, and there was no complication such as incision infection, fracture nonunion, internal fixation failure, and necrosis of the femoral head during the follow-up period. Conclusion FNS treatment of Pauwels Ⅱ and Ⅲ femoral neck fractures is significantly better than CCS treatment in terms of the number of intraoperative X-ray fluoroscopy, the time of weight bearing and fracture healing after operation. Patients can be trained with weight-bearing as soon as possible, which is helpful for fracture healing and hip function recovery.