Proximal femoral fractures (PFFs) are the most frequent type of bone injury among the elderly. In Italy alone, 906,111 hospital admissions for hip fractures were recorded between 2007 and 2017. Globally, due to the aging population, the number of cases is expected to rise to 21.3 million by 2050. In older individuals, fractures of the femoral neck are commonly managed with prosthetic implants. While hemiarthroplasty has long been the standard treatment, total hip arthroplasty (THA) is increasingly favored for more active or functionally demanding patients. Among the surgical options, dual mobility THA (DM-THA) stands out for its potential to significantly reduce postoperative complications, particularly dislocations, when compared to both conventional THA and hemiarthroplasty. This study aimed to determine the most effective surgical strategy—dual mobility THA versus hemiarthroplasty—for managing femoral neck fractures in elderly patients. A thorough literature review was conducted using PubMed, Web of Science, and Scopus, focusing on the most recent and relevant publications. The findings highlight a consistent trend: patients treated with DM-THA generally experience better outcomes than those receiving hemiarthroplasty. Based on current evidence, DM-THA should be regarded as the preferred intervention for elderly individuals with femoral neck fractures, except in cases where severe comorbidities or anesthesia-related risks require a more conservative approach.

Proximal femoral fractures (PFFs) are the most frequent bone fractures in elderly people. In Italy, from 2007 to 2017, there were 906,111 hospitalizations for hip fractures. These fractures are expected to reach up to 21.3 million globally by 2050 because of aging. Femoral neck fractures in elderly people are usually treated with protheses. Hemiarthroplasty has been the treatment of choice. However, high-demand patients require total hip replacement. A dual mobility cup is more powerful than total hip arthroplasty or hemiarthroplasty and has less complications. We did a search of the literature about the best choice between a dual mobility cup and hemiarthroplasty in treatment of femur neck fracture. In this literature review, we found many works that show better results in patients treated with dual mobility total hip arthroplasty, compared to hemiarthroplasty. In elderly people femoral neck fractures, dual mobility total hemiarthroplasty should be the solution of choice except for cases with internal or anesthetic problems, which should have a less invasive intervention.