Abstract: Objective To observe the clinical efficacy of proximal femoral nail antirotation (PFNA) and Gamma nail (TGN) in the treatment of femoral intertrochanteric fractures of elders. To provide clinical evidence for internal fixation choice of the elderly patients with femoral intertrochanteric fractures. Methods Retrospective analysis of 40 cases of elderly patients with femoral intertrochanteric fracture admitted in the orthopaedics of the First Affiliated Hospital of Bengbu Medical College from 2017 to 2018 was made. According to the different operative methods, they were divided into PFNA group (n=20)and TGN group (n=20).The intraoperative blood loss, operation time, hospital stay, postoperative complications, fracture healing time, bone mineral density and Harris hip scores were compared between the two methods. Data were analyzed with SPSS 20.0 statistical software. Results The PFNA group was followed up for 3 to 6 months, while TGN group was followed up for 3 to 6 months. The operation time, blood loss volume in PFNA group were less than those in TGN group, bone mineral density of the PFNA group was superior to the TGN group, and the difference between the two groups was statistically significant (all P<0.05). There was no statistical significance in hospital stay, postoperative complications, fracture healing time between PFNA group and TGN group(all P>0.05). Conclusion PNFA should be considered more preferential than TGN when choosing internal fixation in elderly patients with femoral intertrochanteric fractures.