PURPOSE: The purpose of this paper is to analyze the operating time, timing of ambulation, functional results and complications using the calcar replacement stem for the severely comminuted unstable intertrochanteric fractures in the elderly patients. MATERIALS AND METHODS: From August 1991 through January 2001, 20 elderly patients over the 75 year old patients had undergone bipolar hemiarthroplasty with calcar replacement stem for the treatment of unstable intertrochanteric fractures. RESULTS: The mean operating time was 45 minutes and mean Harris Hip Score was 84.7. Ambulation with walker was started at post-operative 8 days and full weight bearing was 6.9 weeks, each. Complications were 2 cases of wound infection, 1 case of severe thigh pain and 1 case of dislocation. CONCLUSION: Early ambulation, functional restoration and decrease of the complications with bipolar hemiarthroplasty using calcar replacement stem for severely comminuted unstable intertrochanteric fractures in elderly patients, therefore this methods seems to be one of the effective treatments.