The article presents the tactics of treatment of elderly patients with fractures of the femoral neck. Depending on the nature of the fracture, the period from the date of injury presented by the selection of a method of surgical treatment of fractures of the proximal femur.with biomechanically favorable fractures of the femoral neck Pauwels type I-II with displacement of fragments of type Garden II-III up to 3 days after the injury we have produced a minimally invasive percutaneous osteosynthesis beam V-shaped spokes or AO cannulated screws.If after an injury took place over 3 days in patients older than 60 years at subcapital fractures type III of Pauwels, Garden IV of, patients produce primary hip arthroplasty. The article also describes the experience of doing pereoperatsionnogo elderly patients with femoral neck fractures in the preoperative and postoperative phases.