Objective:This study aimed to examine the efficacy of external fixators in treating intertrochanteric fractures in terms of union, functional outcome, and comorbidities.Background:Internal fixation of intertrochanteric fractures in older patients with anesthesia or surgical concerns or in patients with an open fracture has a high complication risk; thus, external fixation should be examined as a semiconservative method to reduce operating time and complications.Patients and methods:twentypatients with intertrochanteric fracture with a wide range of ages and different physical conditions were treated by Ilizarov external fixator.Results:All patients were clinically and radiologically examined for at least six months. There were 15 patients with excellent and good [satisfactory] outcomes, 2 patients with acceptable results, and 3 patients with bad [unsatisfactory] results. Radiological union and fixator removal occurred between 8 and 20 weeks, with a mean of 13.4 weeks. Illness of the pin tract developed in all patients, with one patient developing a very severe infection. Four individuals had a varus malalignment, and one patient had a valgus deformity. Two individuals experienced temporary knee stiffness.Conclusion:External fixation of intertrochanteric fractures and open fractures in older, high-risk patients has been proved to be a dependable, successful, and safe therapeutic option. It involves little operating risk, minimal blood loss, a brief hospital stay, early mobility, and a low rate of morbidity and death.