Abstract: Objective To explore the clinical effect of Asian type PFNA-Ⅱand new Inter Tan in the treatment of elderly unstable intertrochanteric fractures. Methods Sixty patients with unstable intertrochanteric fractures admitted in the Orthopaedic Department of Yuhuan People's Hospital from January 2017 to January 2018 were randomly divided into two groups. Group A were used PFNA-Ⅱinternal fixation, while group B were used Inter Tan internal fixation. The operation time, intraoperative blood loss, intraoperative fluoroscopy time, post-operative drainage volume, the time of postoperative onset, the last follow-up of hip joint function Harris score, fracture healing time, after three months thigh pain, femoral neck shortening, complications were compared between two groups. Results The operation time, intraoperative blood loss, intraoperative fluoroscopy time, postoperative drainage volume in the group A were better than those in the group B, while the time of postoperative onset, fracture healing time, complications, after three months thigh pain, femoral neck shortening, complications in the group B were better than those in the group A(P<0.05). There were no significant differences in the last follow-up of hip joint function Harris score between two groups. Conclusion PFNA-Ⅱand Inter Tan are minimally invasive intramedullary fixation, each has its advantages in the elderly patients with unstable intertrochanteric fracture. The PFNA-Ⅱ has the advantages of short operation time, simple operation, less trauma and less bleeding, while Inter Tan is more reliable, with good compression effect, good biomechanical advantage and stability, less early complications and short fracture healing time, which is conducive to rapid recovery.