A network meta-analysis compared three methods of internal fixation of femoral neck fractures: cannulated compression screws (CCS), dynamic hip screws (DHS), and femoral neck systems (FNS). The study included 23 studies with 55,910 patients. FNS had a statistically significantly higher Harris Hip score versus CCS (MD 3.79, 95% CI 1.44–6.13) and shorter fracture healing time (MD −1.00 months, 95% CI −1.53 to −0.48). Both FNS and CCS showed a lower rate of femoral head necrosis than DHS. CCS had significantly lower intraoperative blood loss compared to FNS and DHS. FNS showed advantages in healing and risk of necrosis over CCS and DHS, but the improvement in Harris Hip score did not reach the minimal clinically important difference. The definitive clinical prevalence of FNS remains uncertain and requires further studies.