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Abstract We conducted this systematic review to evaluate the effectiveness of methods used in fixation of unstable femoral neck fracture in adults and compare the results of fixation by DHS ,cannulated screws ,DCS ,cephalomedullary nail , primary valgus intertrochantric osteotomy fixed by broad DCP.,Targon femoral neck device and medial buttress plate augmentation of cannulated screws fixation. Methodsː We conducted our study by searching Medline and PubMed for studies about fixation of unstable femoral neck fractures in adults and we found twelve papers about different methods of fixation which met our inclusion and exclusion criteria. Our specific outcome measures were Achieved union and complications of different methods of fixation of unstable femoral neck fractures in adults. Resultsː that Targon femoral neck system achieved the best union rates , despite high rates of complications.followed by primary valgus osteotomy and also achieved lower complication rate from other methods of fixation. Conclusionː management of unstable femoral neck fracture in adults by Targon femoral neck system achieved the highest union rate than other methods of fixation but,primary valgus osteotomy is a very good method but itʾs technically demanding and has different complications |