Intertrochanteric fractures of the hip usually occur in a more elderly age group than femoral neck fractures. Unstable intertrochanteric fractures in elderly patients with osteoporotic bone and in poor general health have always represented a particularly difficult problem for orthopaedic surgeon. Difficulties include nails protruding out of the head and neck, collapse into varus, instability, malunion, and nonunion. To promote early full weight-bearing and rapid rehabilitation, 16 elderly patients(more advanced osteoporosis than Singh's index grade III ) with unstable intertrochanteric hip fractures were treated with endoprosthetic replacement as primary fracture management. The patients were returned with maximum activity and weight-bearing status as early as possible postoperatively.