Fracture rate and complications after internal fixation of intertrochanteric hip fractures in patients 75 years of age and older. There is no consensus regarding the optimal treatment of intertrochanteric hip fractures in elderly patients. The goal of the present study was to examine whether there is a decreased rate of complications after internal fixation of intertrochanteric hip fractures in patients 75 years and older, compared to internal fixation performed in younger patients. A total of 589 intertrochanteric hip fractures were treated with internal fixation at one university hospital. The age- and fracture-specific rate of complications was compared in patients 75 years and older and younger patients. Hip fracture surgery was performed more frequently in patients 75 years and older (60%) than in younger patients (42%) (p < 0.001). Within the group of patients 75 years and older, there were no significant differences in the fracture-specific rate of complications between internal fixation with a DHS or Gamma nail. These findings support the view that an anatomic reduction can be safely achieved in elderly patients with a DHS. Additional studies should be performed to establish the optimal treatment of intertrochanteric hip fractures in patients 75 years and older, especially as the age-specific rate of complications after fixation of intertrochanteric hip fractures is not uniform.