Objective To explore the clinical effect of osteotomy and navigation tool in the treatment of intertrochanteric fracture in the elderly. Methods A retrospective analysis of 77 elderly patients with intertrochanteric fracture treated with artificial femoral head replacement with trochanteric handle was made from February 2016 to December 2017. 39 of them were treated with self-developed osteotomy navigation tool (observation group A), 38 with original osteotomy template (control group B). The operative time (JT), total operative time (ZT) bleeding volume (SL), time to get out of bed (XT) and Harris score one year after operation were compared between the two groups. Results 77 cases were followed up for an average of 18 months. The operation time and total operation time of osteotomy in the observation group were shorter than those in the control group, and the amount of bleeding in the operation was less than that in the control group, the difference was statistically significant (P < 0.05). There was no significant difference in Harris score and time of getting out of bed activity between the two groups (P > 0.05). Conclusion During the operation of the replacement of femoral head with trochanteric handle, using the channel operation, which can quickly complete the key operation steps of the operation, thus effectively improving the success rate of the operation.