1079 patients with a femoral neck fracture were randomized to fixation using either a sliding hip screw or multiple cancellous screws. Patients were assessed over a 24-month postoperative period for rates of reoperation. Overall, no significant difference between groups was observed in reoperation rate: 19.7% following fixation with a sliding hip screw group and 21.8% following fixation with multiple cancellous screws. While the rate of avascular necrosis development was significantly higher among patients treated with the sliding hip screw, no significant differences in patient-reported health-related-quality-of-life or function were observed between groups.