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Objective: To investigate the effect of open and closed reduction and internal fixation with hollow nails on the quality of fracture reduction and hip joint function in patients with displaced femoral neck fractures. Methods: This study is a retrospective study. The clinical data of 98 patients with displaced femoral neck fractures were selected. According to different surgical methods, the patients were divided into group A (n=50, open reduction) and group B (n=48, Closed reduction), compare the good and good rate, fracture reduction quality, hip joint function, perioperative index, postoperative complication rate and secondary operation rate between the two groups. Results: The excellent and good rate of patients in group A was 78.00% (39/50) at 6 months after surgery, which was higher than 58.33% (28/48) in group B (P<0.05). There was no difference between the two groups in postoperative weight-bearing time and intraoperative fluoroscopy time (P>0.05); the operation time and hospital stay in group B were shorter than those in group A, and the amount of intraoperative blood loss was less than that in group A (P<0.05). The Harris scores of hip joint function at 1 month, 3 months, and 6 months after operation were higher than those before operation in the two groups, and group A was higher than group B (P<0.05). There was no difference in the incidence of secondary operations and complications between the two groups (P>0.05). The number of type I and type II cases in group A were more than that in group B, and the number of type III cases was less than that in group B (P<0.05). Conclusion: Compared with closed reduction cannulated screw internal fixation, open reduction cannulated screw internal fixation is more damaging, but its postoperative fracture reduction quality and hip joint function improvement effect is better, and it does not increase the incidence of complications and secondary complications. The incidence of surgery. [ABSTRACT FROM AUTHOR]