219 patients with a nondisplaced femoral neck fracture were randomized to treatment with either hemiarthroplasty or screw fixation with two cancellous screws. Patients were followed up at 3, 12, and 24 months postoperatively. Primary outcome was the Harris Hip Score, while secondary outcomes included mobility, pain, quality of life, and rate of reoperation. For the primary outcome, there was no significant difference between groups in HHS at 3, 12, or 24 months. Outcomes which demonstrated significant differences between groups included Timed Up-and-Go test times, incidence of major reoperation, and incidence of major surgical complications, all of which favoured hemiarthroplasty compared to screw fixation.