Abstract Background: In there are femoral head fractures, the majority of these injuries should be treated operatively and the choice of surgical approach and procedure was not settled. Surgical decision and reconstructive options are influenced by patient condition and fracture types. Patients and Methods: Twenty patients with displaced femoral head fractures were surgically treated (ORIF) using surgical dislocation approach selectively. Minimum follow up was 30 months (mean, 48 months; SD, 30.6 months). According to Pipkin classification, we had displaced Type I in 8 hips, type II in ten hips. CT scan evaluation for all patients was done routinely. Radiological evaluation was done according to Matta’s criteria. The heterotopic ossification was graded according to the Brooker classification. Radiographs taken at the last follow up were evaluated and classified according to the Tönnis classification. Clinically, the patients were evaluated with the modified Harris hip score. Results: The mean modified Harris hip score (HHS) was 84 points (range: 72-92) (SD, 7). Radiographically, fracture reduction was anatomic in fourteen hips and imperfect in four with a mean residual fracture displacement of 1.2 mm (SD, 1.65). AVN of the femoral head was found in one patient and underwent THA at 2 years. Two patients developed adventitious bursa on greater trochanter region and excision of trochanteric screws was done and improved. Heterotopic ossification grade I was recorded in three patients in this study until the final follow up but did not affect the function. Conclusion: This technique is recommend for surgeons treating fracture femoral head with or without acetabular fractures as it provide full exposure of the femoral head. As a limitation of this study, the small number of cases and lake of previous studies using the same technique for the same indication. Future studies are required to compare this approach with others regarding the outcome scores and complications