Objective To investigate the operative procedure and the therapeutic effects of unstable femoral intertrochanteric fracture in elderly patients with rebuild septum bronchiale in artificial femoral head replacement. Methods From October 2005 to October 2007, 113 elderly patients with unstable femoral intertrochanteric fracture were treated with artificial femoral head replacement with fixation of femoral greater trochanter and smaller trochanter in the help of bone cement in 58 cases (test group) and with γ-type bone nail in 55 cases (control group). In test group, there were 21 males and 37 females with an average age of 75 years, including 10 cases of type IIIA, 16 cases of type IIIB and 32 cases of type IV according to Evans-Jenson standard. In control group, there were 17 males and 38 females with an average age of 72.5 years,including 13 cases of type IIIA, 14 cases of type IIIB and 28 cases of type IV according to Evans-Jenson standard. All fractures were caused by fall damage. The disease course was 3 hours to 7.5 days (mean 1.4 days). The patients of two group compl icated with osteoporosis, and compl icated by one or several compl ications of coronary heart disease, hypertension, diabetes and chronic bronchitis. And all patients did not had fracture at other sites. There was no significant difference in general data between two groups (P gt; 0.05). Results The operations were successful, the incision healed by first intention. There were significant differences in operation time, operative blood loss and blood-transfusion between two groups (P lt; 0.05). The two group were followed 12-36 months. There were significant differences (P lt; 0.05) in the incidence rate of compl ication and the excellent and good rate of hip function (by Harris standard) between the test group (3.4% and 93.1%) and the control group (16.4% and 70.9%) 12 months after operation. Conclusion The aged patients with intertrochanteric fracture can get good result through caput femoris replacement, and rebuild septum bronchiale is of great significance.