We retrospectively studied 50 patients who underwent salvage procedures for failed compression hip screw (CHS) fixation of intertrochanteric fractures from January 1991 to July 2000. Among these patients, seven underwent revision fixed angle plate surgery; 16 patients underwent bipolar hemiarthroplasty; five patients underwent Austin-Moore hemiarthroplasty; another nine patients underwent total hip arthroplasty; and 13 patients underwent removal of the implant. The age, gender, type of falling accident, osteoporosis status and post-operative ambulation status were recorded. The incidence of failed fixation of CHS was estimated at around 9.7%. A fall was recorded in 52% of cases. There was a significant difference in osteoporosis grade between the failed and successful CHS groups (p < 0.005). There was also better postoperative ambulation in the total hip replacement group compared to the other groups (p = 0.03). Surgical management of nonhealed intertrochanteric fractures is a challenge to orthopedic surgeons. The authors suggest multiple factors, such as fracture geometry, bone quality, preservation of acetabulum cartilage and individual patient factors, be considered when performing salvage procedures for failed CHS.