Intertrochanteric and subtrochanteric femoral fractures are one of the most common proximal femoral fractures especially in the elderly with osteoporotic bones, usually due to low energy trauma like simple falls. The incidence of these fractures is rising because of increasing number of senior citizens with osteoporosis. By 2040 the incidence is estimated to be doubled.A recent surgical procedures as minimally invasive surgery and design of new implants that achieves minimal surgical blood loss, short operative and hospitalization time, low cost, minimal anesthetic risk, the least morbidity and mortality rates, and early weight bearing is favoured to reduce complications.The most commonly used implants have a plate fixed to the lateral side of the femur. A large screw in the femoral head and a sliding mechanism to allow fracture impaction. An interamedullary nail can be used instead of a plate, offering potential advantages such as a smaller incision, less devascularisation of bone and a shorter operating time. An external fixator can be used in a group of high surgical risk elderly patients for such patients prolonged anesthesia and intraoperative blood loss are not well tolerated.Recently (the percutaneous compression plate) a minimally invasive sliding screw plate implant used for pertrachanteric femoral fractures with favourable clinical complications rates and biomechanical results. Bone cement and hydroxy apatite-coated screws bone have been advocated in patient with severe osteoporosis and pathological fractures of the proximal femur in elderly.