Objective: To explore the choice of internal fixation for intertrochanteric fracture of femur combined with lateral wall fracture. Methods: 57 patients with intertrochanteric fractures and lateral wall fractures were divided into groups A and B according to different surgical methods. Group A was treated with dynamic hip screw (DHS), 27 cases; group B was treated with femur proximal femoral nail antirotation (PFNA), 30 cases. The perioperative indicators, hip joint function and postoperative efficacy of the two groups were compared. Results: (1) The operation time, incision length, intraoperative blood loss and hospital stay in group B were significantly better than those in group A (P <0.05); the incidence of complications in group A (14.81%) was significantly higher than that in group B (3.33%) (P <0.05); (2) At the last follow-up, the modified Harris score, hip flexion angle, and 90 ° flexion internal rotation range of the two groups were significantly improved compared with those before surgery, and group B was significantly better than group A (P <0.05); (3) At the last follow-up, the curative effect score of patients in group B was significantly better than that in group A (P <0.05). Conclusion: Both PFNA and DHS can treat intertrochanteric fractures with lateral wall fractures, but PFNA is significantly better than DHS. It has the advantages of short operation time, less surgical trauma, fast postoperative recovery and fewer complications.