Abstract: Objective To explore the clinical effects of total hip replacement (THR)and bipolar femoral head replacement (BFHR)on treatment of elderly patients with femoral neck frac-ture.Methods 74 elderly patients with femoral neck fracture were randomly devided into observa-tion group and control group.The observation group was treated with THR,while the control group was treated with BFHR.Clinical efficacy was compared between the two groups.Results The operating time of the observation group was significantly longer than the control group(P <0. 01),and amounts of blood loss and postoperative drainage were significantly larger than the control group(P <0.01).3 years after operation,Harris score of the observation group was significantly higher than the control group (P <0.05),and there was no significant difference of postoperative complications between two groups (P >0.05).Conclusion Both THR and BFHR can treat femoral neck fracture effectivel.In the clinic,choice of therapies should be carefully considered on the basis of comprehensive factors such as age,physical condition and expected survival time.