Objective To study the indication,surgical technique and clinical results of the uncemented hip arthroplasty for unstable intertrochanteric fractures in elderly patients.Methods Twenty-three elderly patients with unstable interthochanteric fractures were treated with uncemented hip arthroplasty,including 6 males and 17 females with an average age of 77.6 years (range,73-95 years).According to the Evans-Jensen classification,there were 2 cases of type ⅡA,9 of type ⅡB,and 12 of type Ⅲ.Osteoporosis was classified according to the Singh index,there were 2 cases of Ⅳ,8 of Ⅲ,12 of Ⅱ and 1 of Ⅰ.Results All patients were followed up with an average of 31 months (range,12-64 months).The average Harris score improved from 33.1 1±6.58 points preoperatively to 87.12±5.05 points at the time of the last follow-up.Radiologically,there were 16 cases of fixation by bone ingrowth; nonunion of lesser trochante fracture was noted in 3 cases; proximal displacement of greater trochante was found in one patient.Intraoperative proximal femoral fracture was encountered in two cases; deep venous thrombosis was found in three cases and one case died of pulmonary embolism.One case who experienced acute left ventricular failure recovered by medical treatment.There was no aseptic loosening,peri-prosthetic infections,dislocation or ectopic ossification.Conclusion The short-term results of uncemented hip arthroplasty in elderly patients with unstable intertrochanteric fractures were satisfactory.