Older people frequently experience unstable trochanteric femur fractures, which can greatly affect their ability to move around. The treatment's primary goal is to restore function as quickly as possible while minimizing the risk of complications and death. The majority of these fractures are best treated surgically with internal fixation. In cases when the bone quality is poor, the fracture is unstable, or if there are many complications, the overall complication rates are still high, even when intramedullary nails are used. For elderly patients who have intertrochanteric femur fractures and are at high risk of fixation failure or who have associated intraarticular diseases, hip arthroplasty is an alternative to consider. Hip arthroplasty is a good option for patients who cannot stay in bed for an extended period of time due to their condition and who could worsen significantly if their ability to move around is not restored quickly. The surgeon's personal inclination as well as the specifics of the fracture will determine the surgical approach used. The majority of primary and revision femoral stem prostheses are bipolar hemiarthroplasty. Hip arthroplasty had fewer problems and fewer reoperations than intramedullary nails and better early functional result. Although there is no regular pattern of results and a statistically significant difference is not always possible to achieve, intramedullary nails do likely to have a better functional outcome and lower mortality rate in the long run. The function of hip arthroplasty in the management of intertrochanteric femur fractures in the elderly is not yet defined by any standards. The literature provides a general outline of hip arthroplasty's potential applications; however, there are numerous methodological limitations and a lack of proof. Additional research is required to discover the best surgical approach, the features that identify patients who might gain the most from hip arthroplasty, and the types of intertrochanteric fractures most likely to fail internal fixation