50 elderly male patients with displaced intracapsular fractures were randomly assigned to treatment with either internal fixation or arthroplasty. The purpose was to determine the comparative efficacy between these two surgical options for treatment in this patient population. Operative data demonstrated a significantly reduced operative time for internal fixation. Results after one year revealed a higher rate of re-operation and fracture healing complications with internal fixation compared to arthroplasty. No significant differences after one year were noted between groups for pain, mobility or mortality.