Abstract OBJECTIVE To investigate the feasibility of surgical selection and external fixation for osteoporotic fractures of the intertrochanteric femur and to expand its treatment scope. Methods: The femoral head was closed and repositioned, and 3 Stiff pins were crossed into the femoral head neck, and 2 threaded half pins were inserted into the proximal femur and combined to form an irregular quadrilateral fixation. After a mean follow-up of 1613 months, there were no cases of pin dislodgement, femoral head cutting, or secondary hip inversion in this group of 25 cases, and no serious pin tract infection. Conclusion External bone fixation has the advantages of less trauma, less bleeding, shorter operation time, and simpler operation, and the combination of cross-pinning within the head and neck not only improves the reliability of fixation, but also has a better fixation effect on intertrochanteric fractures with osteoporosis, especially for the elderly patients who cannot tolerate internal fixation.