Hip fractures are anatomically categorised in relation to the hip capsule as either: Intracapsular fractures (i.e., at the femoral neck), or Extracapsular fractures (i.e., intertrochanteric or subtrochanteric fractures). Cortical and compact cancellous bone are present in the intertrochanteric region. As a result, these fractures happen along the path of least resistance. It is likely that a combination of compression, bending, torsion, and shear loads causes fractures. Compression and bending forces make up most of the forces contributing to all loads. Stronger in compression than tension is the long bone. Fatigue fracture is brought on by repeated loads that are less than the tensile strength of bone. Each load causes minute fractures in the osseous structure, which eventually combine to form fracture. Either simple or comminute depending on the amount of energy absorbed. Early anatomical reduction and surgical fixation remains the best option to reduce the risk of complications like non-union and avascular necrosis in treating fracture neck femurs. Cancellous screws continue to be the preferred treatment for fixation of neck femur fractures in younger population until the benefit of using sliding hip screws is validated by large multicentric studies. In the geriatric age group, early prosthetic replacement brings down the mortality and morbidity associated with neck femur fractures. Sliding hip screw (DHS) is the best available option for stable inter trochanteric fractures. The use of intramedullary nails e.g. PFN is beneficial in treating inter trochanteric fractures with comminution and loss of lateral buttress. Intramedullary implants have been proven to have increased success rates in subtrochanteric fractures and should be preferred over extramedullary plate fixation systems.