Abstract The early results of 276 femoral head replacements for displaced fractures of the neck of the femur are described. The procedure was performed in the same hospital by two similar groups of surgeons. Either an anterior or a posterior approach was used. Although there was no statistical difference between the rates of infection and dislocation in the two groups, infection and dislocation occurred more commonly in the posterior approach. Misplacement of the prosthesis and fracture of the upper part of the femoral shaft occurred statistically more frequently in the anterior group.