Objective:To investigate the therapeutic effect, functional recovery and long-term prognosis of domestic InterTan intramedullary nail in elderly patients with external wall risk intertrochanteric fracture of femur complicated with hypertension.Methods:The clinical data of 59 elderly patients with lateral wall dangerous intertrochanteric fracture and hypertension admitted to the People′s Hospital of Shexian from January 2017 to June 2022 were retrospectively analyzed. According to different internal fixation methods, the patients were divided into the proximal femoral antispiral intramedullary nail (PFNA) group (28 cases) and the domestic InterTan intramedullary nail group (31 cases). Perioperative data, postoperative pain and hip Harris score were compared between the two groups, and the local and systemic complications were recorded.Results:The fluoroscopy times and intraoperative blood loss in the domestic InterTan intramedullary nail group were higher than those in the PFNA group: (24.36 ± 2.62) times vs. (19.57 ± 2.94) times, (183.09 ± 20.55) ml vs. (171.25 ± 22.47) ml, there were statistical differences ( P<0.05). However, the operation time, hospitalization time, weight bearing and fracture healing time in the domestic InterTan intramedullary nail group were shorter than those in the PFNA group: (72.23 ± 16.47) min vs. (91.43 ± 12.65) min, (13.97 ± 4.52) d vs. (16.43 ± 4.31) d, (4.31 ± 0.63) d vs. (5.38 ± 0.72) d, (11.96 ± 2.51) weeks vs. (13.35 ± 2.75) weeks, there were statistical differences ( P<0.05). One month after operation, the visual analogue scale (VAS) score in the domestic InterTan intramedullary nail group was lower than that in the PFNA group, and the Harris score was higher than that in the PFNA group: (4.58 ± 1.54) scores vs. (5.56 ± 1.73) scores, (64.63 ± 8.36) scores vs.(58.29 ± 7.47) scores, there were statistical differences ( P<0.05). There were no significant differences in the incidence of local complications and systemic complications between the two groups ( P>0.05). Conclusions:Domestic InterTan intramedullary nailing and PFNA have good therapeutic effect on elderly patients with external wall risk intertrochanteric fracture of femur combined with hypertension. Domestic InterTan intramedullary nailing has better anti-rotation effect and stability. However, for patients with poor physical conditions and many complications, PFNA treatment can effectively reduce intraoperative trauma.