Objective To investigate the impact and significance of a precision nursing plan during the surgical manage-ment of femoral neck fractures in elderly patients.Methods From May 2022 to May 2023,70 patients with femoral neck frac-tures,including medium-sized neck and head-type,were randomly divided into a control group and an observation group equally.The two groups were managed with routine nursing interventions and specific nursing interventions,respectively.The two groups were compared in terms of the psychological status,complications,hip joint functions,and prognostic effects.Results After the intervention,the psychological status scores of both two groups significantly decreased.The observation group showed lower psy-chological status scores,indicating better psychological status compared to the control group(P＜0.05).The rate of postopera-tive complications in the observation group was significantly lower than that of the control group(P＜0.05).Additionally,the scores of hip joint function in the observation group were higher than those of the control group(P＜0.05).At the time of dis-charge,the scores of self-care ability in both two groups had increased,and the scores of femoral head necrosis were significantly decreased after 3 months of interventions(P＜0.05).Furthermore,the self-care ability scores in the observation group were higher,and the scores of femoral head necrosis were lower compared to those of the control group,indicating that the prognosis of the observation group was better than that of the control group(P＜0.05).Conclusion The precise nursing interventions could effectively enhance the prognosis of elderly patients with femoral neck fractures and improve their self-care ability.