The increasing incidence of trochanteric fractures renders their treatment a challenging task concerning both medical and increasingly socio-economical questions as well. The majority of these fractures occurs in elderly patients compromised by various preexisting medical problems. The primary goal of treatment therefore has to be early mobilisation to avoid secondary complications. This can only be achieved by operative treatment. Regarding the perioperative management an antibiotic as well as an antithrombotic prophylaxis is advisable. Recent data also suggest to add an enteral nutritional supplement during the postoperative period. The social reintegration depends however primarily upon the rapid restoration of the walking capacity. In this concern the Dynamic Hip Screw (DHS) is an optimal implant for ORIF, since it allows early full weight-bearing and shows a lower complication rate than static implants (e.g. the condylar blade plate).