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A cementless porous-coated femoral prosthesis with a long stem was implanted in seven patients who had untreated comminuted unstable intertrochanteric fractures of the femur associated with a posterior dislocation of the femoral head. The average age of the patients was 35 years (range, 25–52 years). The length of follow-up observation averaged 45 months (range, 23–60 months). The hip rating at the final follow-up examination ranged from 82 to 100 points (average, 96 points). The follow-up roentgenographs of these patients revealed complete consolidation of the fracture site and no evidence of subsidence or loosening of the prosthesis. There was no indication of detrimental bone remodeling phenomenon in this series. Hemiarthroplasty with a cementless, porous-coated, long-stem prosthesis can be effective treatment for this complex fracture dislocation.