BACKGROUND:Osteoporosis-induced unstable intertrochanteric fracture has a high failure rate and incidence of complications, and treatment is stil controversial. OBJECTIVE:To compare the clinical effects of proximal femoral nail anti-rotation and modified proximal femoral nail anti-rotation II for treating intertrochanteric fractures in the elderly. METHODS: Data of 26 patients with intertrochanteric fracture who were treated with surgery in the Department of Orthopedic Surgery, Pingguo County People’s Hospital were retrospectively analyzed. Of them, 13 cases received proximal femoral nail anti-rotation, and 13 cases received modified proximal femoral nail anti-rotation II. RESULTS AND CONCLUSION:The patients in both groups were folowed-up for 12 months, no drop out. Hip function restored perfectly after implantation in both groups. No significant difference in Harris score and fracture healing time was detected between the two groups. The incidence of pain in the lower limbs was lower in the proximal femoral nail anti-rotation II group than in the proximal femoral nail anti-rotation group (P < 0.05). Results verified that the therapeutic effect of modified proximal femoral nail anti-rotation II was better than proximal femoral nail anti-rotation, and it is safe and reliable.