Materials and methods: 48 cases of Garden type III and IV fracture neck of femur of both genders were divided equally (24) into 2 groups. Group I patients were treated with fixation with 3 cancellous screws and group II patients with versus 2 cancellous screws and fibular graft. Parameter such as mode of injury, operative blood loss, time of surgery, time to union, Harris hip score and Kyle’s criteria and complication.

Ns in each group was recorded

Results: Group I had 12 males and 12 females and group II had 13 males and 11 females. Mode of injury was RTA seen in 16 and 15, fall in 5 and 7 and violence in 3 and 2, intra- operative blood loss (ml) was 67.4 and 70.2, time to union was 12 weeks seen in 3 and 3, 12-20 weeks in 7 and 9 and 20-24 weeks in 11 and 10 and 6 months- 1 year in 3 and 2, Harris hip score and Kyle’s criteria found to be excellent in 14 and 18, good in 2 and 6 and poor in 8 and 0 in group I and II respectively. The difference was significant (p<0.05). Common complications were superficial infection in 3 and 1, non-union in 1 and delayed union in 2 and 1 in group I and II respectively. The difference was significant (p<0.05).

Conclusion: 2 CC screws with fibular graft is an alternative in fixation of femoral neck fracture and it provides an osteogenic environment, structural support, and biological healing with less complications.