Aims: The aim of this prospective study is to compare the results regarding non-union and AVN of two different methods of treatment after displaced femoral neck fractures in young and middle age population.

Methods: Between 1980–1998 we treated 91 patients with displaced femoral neck fractures. In 56 patients (Group A) we performed open reduction, dynamic screw fixation and gluteus minimus muscle pedicle bone graft from greater trochanter inserted through a tunnel prepared parallel to screw. 38 patients had fracture Type Garden III and 18 Garden IV. In 35 patients (Group B) after closed reduction the fracture was fixed with three parallel canullated screws. 24 had fracture Type Garden III and 11 Type IV. All patients were operated within 24 hours. After reduction, Garden Index of 1600±100/1800±100 was acceptable. Follow up varied between 3 to 12 years. Fischer’s Exact test was used to evaluate the results.

Results: 3 patients (5,4%) of Group A and 2 patients (5,7%) of Group B developed non-union. AVN was evident in 9 patients (17%) of Group A and in 6 patients (16,2%) of Group B.

Conclusions: Displaced intracapsular hip fractures are a challenge. Preservation of the femoral head should be the goal of treatment. The rate of non-union in the 2 groups (p:0, 942) as well that of AVN (p:0, 893) did not seem to differ statistically significally. The use of muscle pedicle bone graft did not seem to alter the incidence of complications. We believe that open reduction should be performed in fractures that cannot be reduced closed in younger patients.