The principle in the treatment of an elderly patient with an intertrochanteric fracture has swung from traction to internal fixation due to complication such as pneumonia, skin ulcer, and thromboembolic disease, etc. Many surgeons have used sliding compression screw for trochanteric fracture fixation which was regarded as a most effective device to manage the fracture. but, they have reported several risk factors to cause fixation failure such as screw impaction or loosening, because of osteoporosis, large defect on posteromedial aspect of neck, eccentric fixation of lag screw. The aim of the present investigation was to study the relationships between the type of fracture, the trabecular bone grading of proximal femur, reduction status, the implant position and the extent of impaction or loosening of the comression screw We studied 47 elderly patients (age>60) who were managed using of compression hip screw as operative management and followed more than 6months after operative treatment at Department of orthopaedic surgery, Ewha womens university Mokdong hospital from 1994 to 1998. The results were as follows 1. Screw impaction or loosening was developed in 7cases of 47cases after internal fixation. 2. Of 7cases, 2cases were stable fracture (modified Evans type I,II) and 5cases unstable (modified Evans type III,IV,V). 3. Of 7cases, 3cases were hightrabecula grade (grade VI,V,IV), 4cases were low trabecula grade (grade I,II,III). 4. No siginificant diffierence of impaction or loosening development was in screw position. 5. Of 7cases, 2cases were anatomical reduction and 5cases medial reduction.