Femoral intertrochanteric fracture is a common disease in the elderly, and with the increase in human life expectancy and the increasing severity of osteoporosis in the elderly, the incidence of this fracture is increasing year by year, and the age of onset is also rising. Surgery is the only active and effective treatment modality for the elderly, who suffer from one or more medical diseases and have a high disability and mortality rate with conservative treatment and long-term bed rest. The patient was placed supine on the traction bed with the C-arm X-ray machine facing the hip of the affected limb and placed obliquely between the two lower limbs. After satisfying the patient, the patient was routinely disinfected and toweled, and a longitudinal incision of about 100px was made about 5 cm above the greater trochanter to determine the center of the apex of the greater trochanter as the entry point. The C-arm X-ray machine was used to monitor the placement of the threaded guide pin of the hip compression screw, so that the guide pin was located in the middle and lower 1/3 of the femoral head in the orthogonal view and in the middle of the femoral head neck in the lateral view, and the length of the required hip compression screw was measured. The incision was closed layer by layer. The operation is completed. The operation time is usually controlled within 1 hour, and the bleeding volume is usually less than 100 ml. The need for surgical treatment of intertrochanteric fracture in elderly patients Intertrochanteric fracture is a common disease in the elderly, and in the past, patients and their families could not accept the concept of surgical treatment because of the patient’s age and the combination of various medical diseases (such as hypertension, heart disease, diabetes, etc.), and the patient’s poor tolerance of prolonged surgery, so non-operative treatment was often used. Non-surgical treatment. The most commonly used treatment is traction, which usually requires 90-100 days of bed rest. Although the fracture can eventually heal, the patient suffers a lot due to prolonged bed rest and inconvenient movement of the affected limb, and it is not easy to care for the patient, and often brings more serious complications to the patient, such as decubitus ulcer, pneumonia, urinary tract infection, hip entropion, deep vein thrombosis of the lower limb, cerebral thrombosis, etc. The disability rate and mortality rate are significantly higher, and it is reported that about 15% to 20% of patients die from post-fracture complications. Some scholars have reported that the mortality rate of conservative treatment is as high as 41%, so conservative treatment is now gradually denied. In recent years, there has been a trend toward early surgical treatment of high-grade femoral intertrochanteric fractures, which reduces bed rest time and enables early bed mobility, alleviates and shortens the patient’s pain time, facilitates care, reduces the above-mentioned complications, prevents hip inversion deformity, and reduces mortality. With the continuous development of medical technology, internal fixation is more solid and reliable, less traumatic and more convenient to operate. At the same time, the treatment of comorbidities is more effective, and the prevention and treatment of surgical complications are gradually standardized, which has contributed to the feasibility of surgery for elderly patients. After surgery, patients’ pain is reduced, care is facilitated, quality of life is improved, and symptoms related to medical diseases are reduced. With the continuous improvement of technical means and comprehensive medical level, age is no longer a contraindication to surgery. However, due to their own characteristics, elderly patients require less trauma, firm fixation, shorter operation time, fewer postoperative complications, and the ability to get out of bed early. Intramedullary nailing of the proximal femur has the advantages of simple operation, short operation time, firm fixation, less damage to bone strength, low cost, less injury, less bleeding, and high fracture healing rate, which is suitable for the operation of elderly patients with intertrochanteric femoral fracture in China, and is a surgical method worthy of clinical promotion.