Objective To evaluate the therapeutic effect of minimally invasive treatment on fresh femoral neck fractures in aged patients using closed reduction and percutaneous compressing cannulated screws.  Methods Totally 145 aged patients with fresh femoral neck fractures treated during May 1997 to December 2005 were retrospectively analyzed. Seven cases were Garden type I

54 Garden typeⅡ

78 Garden type Ⅲ and 6 Garden type Ⅳ.  Results The follow-up period was 12-104 months and the average was 46.2 months. Fractures in 139 cases recovered and bone nonunion occurred in 6 cases

with the fracture healing rate of 95.9%. Femoral head ischemic necrosis occurred in 17 cases (17/145

the ischemic necrosis rate of 11.7%). Wherein the fracture healing rate of Garden type Ⅳ fracture was 83.3% and the femoral head ischemic necrosis rate was 66.7%. The function evaluation of hip joint showed that excellent outcome in 58 cases

good outcome in 73 and poor outcome in 14.  Conclusion Minimally invasive treatment with closed reduction and percutaneous compressing cannulated screws for fresh femoral neck fracture in aged patients has the advantages of minimal injury

stable fixation

early functional exercise and high fracture healing rate etc. However

hip joint replacement is suggested in managing fracture of Garden type Ⅳ.