Introduction: Proximal femur fracture of the seniors is often „omen“ for their life. These fractures are the most frequent cause of acute hospitalization of the aged and on the contrary to previous years the procedures are considered as emergent – life saving. Objective: The aim of the study was to find out which of the contemporary used surgical procedures for the treatment of unstable femoral neck fractures at the Department of Trauma Surgery in Košice yield in the lowest number of failures and postoperative complications. Subsequently we have analyzed changes in surgical treatment of these fractures in two time periods (1999–2001) and (2002–2004) respectively. According to review of the literature and our knowledge we tried to suppose algorithm of their treatment. Material and methods: There were 563 patients over 65 years were assigned to the retrospective clinical trial. They underwent the internal fixation or arthroplasty for unstable femoral neck fractures between January 1999 and December 2004 and were registered at least one year after the surgery. Results and conclusion: The results from the clinical trial show that it is more suitable to use internal fixation for biologically younger seniors with fractures of proximal femur. Hemiarthroplasty is indicated for the patients with assumed short term life expectancy and total hip arthroplasty remains the method of choice for the treatment of the failure of the other surgical procedures. There is decrease of number of implanted hemiarthroplasties in comparison of two analyzed time periods. Moreover, number of treated patients in the later period has increased.

        Key words: femoral neck fractures – seniors – internal fixations – arthroplasty