Objective Through the finite element analysis, the stress distribution and fracture stability of femoral intertrochanteric fracture with fracture of lateral wall treated with PFNA and locking plate of proximal femur were studied.Methods A 75 year old healthy volunteer was selected as the study object. The slice images from pelvis to middle femur were scanned by CT. The cortical and cancellous bone of proximal femur were constructed in Mimics 14.0 and Geomagic studio.And in cero3.0, the computer models of PFNA and locking plate are designed according to parameters. In ABAQUS 6.12, the stress changes of internal fixation and fracture end were studied.Results (1) The internal fixation stress of PFNA + tension and PFNA model was concentrated in the joint of screw blade and main nail, while that of locking plate model was concentrated in the joint of two screws under the femoral neck and steel plate. (2) In the femoral head area, locking plate model locking plate model>PFNA + tension band model,there was significant difference (P < 0.001).(3) The stress and displacement in PFNA model were significant higher than PFNA + tension band model and locking plate model in the lower fracture area (P < 0.001). In the upper fracture area, PFNA model was significantly smaller than PFNA + tension band model and locking plate model, but the displacement was significantly larger than PFNA + tension band model and locking plate model (P < 0.001).Conclusion PFNA combined with band fixation in the treatment of femoral intertrochanteric fracture with fracture of lateral wall could reduce the stress of internal screw or hollow nail of femoral head, and it is beneficial to the stability of fracture.