OBJECTIVE: To investigate the treatment of intertrochanteric fractures in osteoporotic patients by analyzing the results of powered hip screw (DHS) surgery for intertrochanteric fractures after artificial femoral head replacement and revision. METHODS: Using a retrospective method, 102 elderly patients with intertrochanteric fractures were treated with powered DHS, and 65 cases were treated with artificial femoral head replacement after loosening of DHS internal fixation. Results: In the DHS group, 63.7% of the internal fixation penetrated the bone cortex, while in the artificial femoral head revision patients, there was no obvious basis for the loosening of the prosthesis, and there was a significant difference in the loosening rate between the two groups. Conclusion: Artificial femoral head replacement for patients with osteoporotic intertrochanteric fractures is associated with earlier functional recovery and fewer complications such as postoperative loosening.