PURPOSE : The goal of treatment in elderly patients with hip fractures is restoration of function to preoperative ambulatory statuf as early as possible. The dementia patients who live in the asylum for the old need longer rehabilitation program for restoration of function, especially walking ability. The authors compare the modalities of the treatment for the hip fracture in the view point of walking ability. MATERIALS and METHODS : The twenty-eight dementia patients were operated due to hip fracture. Femur neck fractures were 7 cases, and femur intertrochanteric fractures were 21 cases. The authors analyze these patient on the recovery of walking ability. One patient who died immediately after operation was excluded in thil study. The patients were divided into two groups. Of 27 patients, 13 patients were treated with osteosynthesis(Group I), and remaining 14 patients were treated with hemidrthroplasy(Group II). RESULTS: Fixation loss was treated with hemiarthroplasty in two case of osteosynthesis. The dislocation was treated with open reduction in one cafe of hemiarthioplasty. In the group I, the walking abilities were significantly different between the preoperative(3.85) and the postoperative at 2 weeks(2.46), at 2 months(2.73) and at the final follow-up(2.55)(P<0.05). In the group II, the walking abilities were not significantly different between the preoperative (2.57) and the postoperative at 2 weeks(2.14), at 2 months(2.36) and at the final follow- up(2.29)(P>0.05). CONCLUSION : Although there is no difference between two groups in final walking ability, The group treated with endoprosthesis showed earlier recovery of safting ability.