〔Abstract〕 Objective To observe and analyze the clinical effects of hollow compression screw nails and sartorius muscle bone flap transplantation in young and middle-aged patients with femoral neck fracture. Methods Selected 62 young and middleaged patients with femoral neck fractures who were treated in Sanming Hospital of Integrated Traditional Chinese and WesternMedicine from February 2018 to February 2020. They were divided into control group and observation group by number table method, each with 31 example. The control group was treated with hollow screw internal fixation alone, and the observation group was treated with hollow compression screw nail and sartorius muscle bone flap transplantation. The clinical treatment situation and effect of the two groups were retrospectively analyzed. Results There was no statistically significant difference in the operation time and intraoperative blood loss between the two groups of patients (P > 0.05); the hospitalization time and fracture healing time of the observation group were significantly shorter than those of the control group, and the difference was statistically significant (P < 0.05). The total effective rate of clinical treatment in the observation group was 93.55%, which was significantly higher than the control group's 80.65%. The difference was statistically significant (P < 0.05). In terms of the rate of femoral head necrosis, the rate of femoral head necrosis of the observation group (0.00%) was significantly lower than that of the control group (12.90%), and the difference was statistically significant (P < 0.05). Conclusion For young and middle-aged patients with femoral neck fracture, the effect of hollow compression screw nail and sartorius muscle bone flap transplantation is significant, the hospitalization time is short, the recovery speed is fast, the necrosis rate is low, and the clinical effect is high.