Objective:To compare the clinical efficacy between proximal femoral biomimetic intramedullary nail (PFBN) and traditional proximal femoral anti-rotation intramedullary nail (PFNA) in the treatment of senile osteoporotic intertrochanteric fractures.Methods:The data were retrospectively analyzed of the 92 elderly patients with osteoporotic intertrochanteric fracture who had been treated at Department of Orthopedics, People's Hospital of Xinjiang Uygur Autonomous Region from April to October in 2021. According to their internal fixation methods, the patients were divided into 2 groups.In the PFBN group of 46 patients, there were 22 males and 24 females, with an age of (75.7±5.2) years and time from injury to operation of (3.1±0.4) d; in the PFNA group of 46 patients, there were 20 males and 26 females, with an age of (75.3±4.2) years and time from injury to operation of (3.3±0.5) d. Recorded were the operation time, intraoperative blood loss, hospital stay, fracture reduction quality, postoperative weight bearing time, hip function and complications at the last follow-up.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The operation time in the PFBN group was (47.3±11.4) min, significantly longer than that in the PFNA group [(39.2±15.3) min] ( P<0.05); the postoperative weight-bearing time in the former was (7.9±2.7) d, significantly shorter than that in the PFNA group [(21.2±5.7) d] ( P<0.05). There were no significant differences between the 2 groups in the intraoperative blood loss [(130.6±21.3) mL versus (123.5±17.8) mL], hospital stay [(4.2±1.6) d versus (4.6±2.1) d], the excellent and good rate of Francisco score [89.1% (41/46) versus 87.0% (40/46)], fracture healing time [(12.3±0.5) weeks versus (12.6±0.7) weeks], or the excellent and good rate of Harris hip score at the last follow-up [89.1% (41/46) versus 87.0% (40/46)] (all P>0.05). Conclusion:Both PFBN and PFNA can achieve satisfactory clinical results in the treatment of osteoporotic intertrochanteric fractures in the elderly patients, but PFBN may provide more reliable early stability and reduce patient bedtime than PFNA.