Objective To discuss and study the clinical efficacy and significance of 16 slice spiral CT three dimensional reconstruction in the treatment of intertrochanteric fractures. Methods 100 cases of patients with intertrochanteric fracture of femur in our hospital were treated with 16 slice spiral CT 3D reconstruction and X-ray examination. According to the numbers of major fractures and the stability of the fracture, the continuity and stability of the fracture were evaluated. Results There were significant differences between the 16 slice spiral CT reconstruction and X-ray measurement (P<0.05).It was closer to the results of surgery, it had no differences (P＜0.05). Conclusion The 16 slice spiral CT 3D reconstruction can be more accurate to show the anatomic changes of the femoral intertrochanteric fracture and show fracture site conditions and stability, the number of fracture fragments better. Compared with the conventional X-ray examination, it is more scientific and accurate so that it can better guide the clinical setting and the treatment plan with pertinence; At the same time, it provides a reference for the development of internal fixation or replacement of prosthesis, in a certain degree, the risk of complications after treatment and operation can be decreased, it has an important significance to promote the treatment and recovery of patients