Abstract: Objective To observe the effects of internal fixation with proximal femoral nail anti-rotation(PFNA)in patients with femoral intertrochanteric fractures. Methods A total of 206 patients with femoral intertrochanteric fractures were divided into PFNA group(n=94)and anatomic proximal femoral locking plate(ALP)group(n=112). According to the propensity score, 42 cases were separately selected from each of the above two groups as PFNA subgroup and ALP subgroup. The perioperative indexes, serum skeletal muscle injury indexes ［creatine kinase(CK), myoglobin(Myo)］, the Hip Function Score(Harris Score)and incidence of complications were compared between the two groups. Results The incision, operation duration, first ambulation time, hospital stay and fracture healing time of the PFNA subgroup were all significantly shorter than those of the ALP subgroup, and the blood loss was significantly less than that of the ALP subgroup(P<0.05). The levels of serum CK and Myo in the PFNA group at 2, 24 and 72 h after operation were significantly lower than those in the ALP subgroup(P<0.05). The Harris scores in the PFNA subgroup at 1month, 3 and 6 months after surgery were significantly higher than those in the ALP subgroup(P<0.05). The excellent rates of Harris score in PFNA subgroup at 3 and 6 months after operation were significantly higher than those in ALP subgroup(P<0.05). The incidence rate of total postoperative complications in the PFNA subgroup was significantly lower than that in the ALP subgroup(4.76% versus 23.81%, P<0.05). Conclusion PFNA internal fixation in the treatment of femoral intertrochanteric fractures has the advantages of less trauma, faster fracture healing as well as functional - recovery and fewer complications.