Objective To compare the effect of hip artificial replacement and DHS internal fixation for the treatment of intertrochanteric fracture, and investigate the difference of the two method. Methods Eighty-six pa- tients with intertrochanterie fracture patients were treated with hip arthroplasty, and dynamic hip screw. The pa- tients were followed up for 6 months, and compared the operation rime, blood loss, postoperative complications, sur- vival rate, postoperative hip function score and lose situation. Results There was no significant difference in opera- tion time,blood loss,postoperative complications,in local symptoms hip varus deformation occured in the DHS inter- hal fixation because lag screw cut-our and the collapse of the medial cortex, hip and thigh pain oecured in artificial re- placement,hip function score dropped 9.5 % in DHS and 9.2% in artificial replacement. Conclusion For elderly patients, eomminuted fracture and osteoporosis, and other types of unstable intertrochanteric fracture patients, the primary purpose of surgery is to provide to patients more activities of the early conditions,so hip arthroplasty can be used to the treatment of intertrochanteric fracture,as a reasonable replacement surgery.