Background: Intertrochanteric fracture is one of the most frequent fractures of the hip particularly in the elderly with osteoporotic bones. Internal fixation is the gold standard therapy. However, it may be hard in the high-risk population.

Aim of the study: to evaluate clinical, radiological and complications outcome of trochanteric fracture in high risk patients treated by percutaneous external fixation..

Patients and Methods: 20 high-risk patients hospitalized in Al Azhar University (Al-Hussien hospital) in addition to kafr El-Sheikh general hospital (August 2020 to February 2022), were treated with an external fixation done under local anaesthesia. There were 8 males and 12 women. Mean age was 70.80 (57-84) years.

Results: The average operational time was 28.85 minutes. Hospital stay was brief, with an average of 1-2 days. No intraoperative problems were found. Blood loss was low and none of the patients had any blood transfusion. All fractures healed within a average 12.05 weeks. Two patients developed a superficial pin-tract infection as a result of their treatment (10 percent ). Four (20%) of the patients had a shortening of the fracture. Revision fixation was performed on a patient with implant failure in 5% of cases without any complications. At 12 months, there were no patients with knee mobility restrictions. Pre-injury and 12-month functional scores for daily activities.

Conclusion: Treatment of trochanteric fractures is safe and successful when externally fixed. Minimal anaesthetic and surgical risks; no blood loss; short hospital stay; early mobilisation; low morbidity and mortality; and a quick return to work.