The surgical treatment of osteoporotic fractures is technically demanding. The poor mechanical properties of the bone make it difficult to obtain stable fixation and thus early movement. The implants and methods used to treat this fracture in the young are often ineffective in the elderly. The long-term functional consequences of fracture depend on surgical success, as much in this group of patients as in any other. Surgical results, and therefore subsequent quality of life, are impaired by the inherent difficulties of reconstructing and achieving union of fractures in the osteoporotic bone.