The so-called trochanteric comminuted fracture is a comminuted fracture of the proximal femur between the trochanteric ramus. Comminuted fractures between the trochanteric ramus usually occur in elderly and frail patients with osteoporosis, and the vast majority of them require surgical treatment. If the fracture is well aligned, the cervical stem angle exists, the anteversion angle exists, and there is no significant displacement of the fracture, surgical treatment can be considered. In addition, some patients who are too old and frail to tolerate surgery have no choice but to choose conservative treatment. Continuous bone traction of the lower extremity can be used, and the fracture is usually healed after 6-8 weeks of traction therapy. If the fracture is poorly aligned, the cervical stem angle is lost, the anteversion angle is significantly altered, and the patient requires early mobility to prevent complications due to prolonged bed rest, then surgery may be considered. Usually PFNA is used for internal fixation, which is more effective and relatively secure and allows for early functional exercise of the joint.