Objective: To explore the effect of lengthened artificial femoral head replacement combined with accelerated rehabilitation surgery in the treatment of unstable intertrochanteric femoral fractures in the elderly patients. Methods: Twelve unstable intertrochanteric fractures treated with artificial femoral head replacement in combination with accelerate rehabilitation surgical treatment from June 2014 to June 2015 were enrolled in this study. There were 9 left legs and 3 right legs. Ages were 73–89 (average 84.3) years; 2 males and 10 females. Three cases were Evans-Jensen III, 5 cases were Evans-Jensen IV, 4 case were Evans-Jensen V. Results: The operation time ranged from 55 to 75 min, with an average of 64.5 min. Intraoperative blood loss was 150–270 mL (180 mL on average), and no blood transfusion was performed. Postoperative ultrasonography showed two cases of intravenous gastrocnemius embolism, 1 case of lacunar cerebral infarction, and 1 case rupture of the wound. The average Harris score was 83.5 points at 2 weeks after surgery; the average Harris score was 88.6 points at 6 months after surgery; the choiceness rate was 89.3%; the average follow-up was 16 months, and the femoral intertrochanteric fractures healed well. Conclusion: The combination of longer handle artificial femoral head set technique with accelerating rehabilitation concept of surgical in treating elderly unstable intertrochanteric fractures is an effective method, but need to master the operation indications strictly and intraoperative operating skills.