ObjectiveTo compare the effectiveness and complications of proximal femoral nail antirotation (PFNA) and InterTAN nail in treatment of elderly intertrochanteric fractures. MethodsA total of 178 patients with intertrochanteric fractures between January 2011 and June 2013 were enrolled. PFNA was used in 100 cases (PFNA group) and InterTAN in 78 cases (InterTAN group). No significant difference was found in gender, age, side of fracture, cause of injury, fracture classification, and time between injury and operation between 2 groups (P>0.05). The operation time, intraoperative blood loss, intraoperative fluoroscopy time, postoperative complications, hospitalization time, fracture healing time, and Harris score were compared between 2 groups to evaluate the effectiveness. ResultsThe operation time, intraoperative blood loss, intraoperative fluoroscopy time in PFNA group were significantly less than those in InterTAN group (P<0.05). The hospitalization time had no significant difference between the 2 groups (t=1.270, P=0.206). Primary healing was obtained in the others except 2 cases having red and swollen in each group respectively. Ninety-two cases of PFNA group and 63 cases of InterTAN group were followed up 11 months on average (range, 8-16 months). In the patients who were lost, there were 4 deaths in PFNA group and 3 deaths in InterTAN group. The complication rate was 4.2% in PFNA group (2 cases of deep venous thrombosis and 2 cases of hip varus) and was 4.5% in InterTAN group (1 case of deep venous thrombosis and 2 cases of hip varus), showing no significant difference between 2 groups (χ2=0.077, P=0.782). X-ray showed that the fracture line disappeared; no complications of malunion, bone nonunion, infection, and loosening of internal fixation occurred. The patients could walk normally. The healing time and Harris hip scores at last follow-up showed no significant difference between 2 groups (t=1.324, P=0.188; t=1.594, P=0.113). ConclusionPFNA is suitable for elderly patients with osteoporosis in treatment of femoral intertrochanteric fracture; InterTAN can be a better choice for younger patients or patients with unstable fracture.