- With a growing percentage of elderly people in the population and, correspondingly, an increasing rate of fractures of the proximal femur, the question how to stabilize medial femoral-neck fractures is gaining increasing importance. Especially in Hungary and Scandinavian countries, femoral-head-preserving surgery is advocated. However, the main problems of this procedure are re-dislocation and necrosis of the femoral head. Encouraged by two theoretical mathematical considerations, a biomechanical experiment was performed to investigate two different methods of screw fixation of medial femoral-neck fractures. The results showed that a head-preserving internal fixation with two cranial screws and a three-point supported screw at the bottom of the neck had distinct biomechanical advantages compared to conventional screw fixation. This has encouraged us to more frequently perform this minimally invasive and head-preserving surgery in Pauwels I and II medial fractures of the femoral head.