Our retrospective study of hip arthroplasty at the Kayes regional hospital showed us the effectiveness of this technique in the management of femoral neck fractures in the elderly. It allows us to avoid not only complications related to osteosynthesis, but also complications of decubitus. Given the increasing frequency of femoral neck fractures, the use of arthroplasty is a legitimate way to reduce the morbidity associated with this pathology. Total hip replacement is the most effective technique but its high cost is a real obstacle for developing countries.