Geriatric hip fractures are problematic fractures with their high complication and mortality rates. Arthroplasty is preferred primarily in the surgical management of femoral neck fractures. While stable intertrochanteric fractures can successfully be managed with both intramedullary and extramedullary fixation methods, intramedullary fixation has been more widely accepted in the management of unstable intertrochanteric and subtrochanteric fractures due to its biomechanical advantages. However, extramedullary fixation can be an alternative option if minimally invasive surgery is used to avoid complications of intramedullary fixation in selected cases. Osteoporosis may cause both loss of initial reduction and failure of the implant construct. Locked plate technology has been developed as a solution to be used in osteoporotic geriatric hip fracture fixation. Failure of obtaining good reduction of the fracture is the main reason in poor results after surgical management of this group of patients.