Objective To investigate the safety and effectiveness of closed reduction with intramedullary nailing sur-gery on the femoral intertrochanteric fractures in elderly patients under 48 h green channel unit.Methods The pa-tients were divided into 48 h group(31 cases were treated with closed reduction intramedullary nail surgery within 48 h in the green channel unit)and conventional group(30 cases were treated with closed reduction intramedullary nail surgery 48 h after admission)by means of preoperative informed consent.The operation status,pain VAS,Harris score and complications of the two groups were recorded.Results All patients were followed up for 9~16(11.12±3.93)months.There were no statistical differences in operation time and blood loss between the two groups(P>0.05).The first walking time and hospitalization time in 48 h group were shorter than those in conventional group(P<0.05).Pain VAS at 1 month and 48 h after surgery was lower than that of the conventional group(P<0.05),and there was no statistical difference between the two groups at 6 months and the last follow-up(P>0.05).The Harris score of the 48 h group was higher than that of the conventional group at 1 month,6 months and at the last fol-low-up(P<0.05).The incidence of postoperative complications in 48 h group was lower than that in conventional group(P<0.05).Conclusions 48 h closed reduction intramedullary nail surgery under the green channel unit can effectively shorten the length of hospital stay,reduce complications,and facilitate patients to leave bed early for func-tional exercise.