Abstract: Objective:To compare the clinical effect of elderly patients with osteoporotic intertrochanteric fracture with the different treatment.Methods:Two hundred and sixty-eight old patients with osteoporotic intertrochanteric fracture were investigated retrospectively.All patients were divided into expectant treatment group (68 cases),the hollow nail group (36 cases),Richard nail group (136 cases),and proximal femoral nail (PFN) (28 cases).Results:There were 200 patients that underwent the surgical treatment.One hundred and ninty-seven patients received fracture healing and 3 patients died.The average healing time was 2.6 months.Meanwhile,in the conservative treatment group 62 patients received fracture healing and 22 patients died.The average healing time was 4.2 months.The effect of the surgical treatment is better than the conservative treatment (P<0.01).There were no coxa vara,the internal fixation bending,cortical bone screw implant rupture in the PFN and Richard screw fixation treatment group.The coxa vara occurred in 17 patients with cannulated screws fixation.Conclusions:Elderly patients with osteoporotic intertrochanteric fractures should be treated on the basis of the body condition as soon as possible.The internal fixation treatment should be given priority.The ideal internal fixation should be to reduce complications,reduce bone loss in the intertrochanteric area,strongly sustaining,fracture healing,functional recovery.