Aims and Methods: Hungary, 60% (3500 cases annually) of all fresh intracapsular femoral neck fractures are traditionally treated by osteosynthesis. Since 1990 nailing has been replaced: from 01.11.1990 to 31.08.2002 the authors performed 3092 procedures using percutaneous double cannulated screw fixation combined with a special tension band plate. The authors based the development of their In technique on results from research done by Woodhouse and Rösing. They proved by animal experiment that total femoral head ischaemia will already lead to irreversible necroses after just 6 hours. Results: The rate of late femoral head collapse at 3–6 years follow-up assessment is significantly lower if osteosynthesis is performed within 6 hours after the accident, i.e. in the phase of reversible ischaemia (p< 0,001). Followup assessment after 3–4 years was possible within the frame of international collaborations (SAHFE) with the same initial results for two groups treated by cannulated screw in 1993–94 and 1997–98 respectively. Emergency treatment also has a favourable somatomental effect on elderly patients. Conclusions: In a work-up of the 3 year follow-up results of 486 femoral neck fracture patients operated over a 2 year period, it was found that reposition and osteosynthesis done within 6 hours significantly decreased the ratio of the development of late femoral head necrosis and non-union. In addition to surgery performed within a short period of time, we consider that the exact anatomical repositioning and the correct placing of the osteosynthesis materials, that is, a good surgical technique is very important.