Abstract:[Objective] To compare the clinical effects of Artificial hip arthroplasty and internal fixation in the treatment of femoral intertrochanteric fractures in elderly.[Methods]A retrospective analysis of 120 elderly patients with femoral intertrochanteric fractures who received surgical treatment from July 2017 to December 2018, 60 patients in the arthroplasty group received hip arthroplasty, and 60 patients in the fixed group received PFNA internal fixation treatment. The preoperative ,perioperative, follow-up and imaging data of the two groups were compared.[Results] The fixed group was superior to the arthroplasty group in operation time, intraoperative blood loss, incision length and postoperative drainage volume, while the arthroplasty group was significantly superior to the fixed group in the number of intraoperative fluoroscopy and hospitalization time,All the differences were statistically significant (P<0.05). Both groups of patients were followed up for 12 to 36 months, with an average of (20.01±6.76) months. The post-operative walking time and full weight-bearing activity time of arthroplasty group were significantly earlier than those in the fixed group, with statistical significance (P<0.05).The VAS scores in both groups decreased significantly over time,and the Harris score of hip joint function was significantly increased,with statistical significance at different time points (P<0.05). One month after surgery, the VAS score of the fixed group was lower than that of the arthroplasty group, and the difference was statistically significant (P<0.05).There was no significant difference in VAS scores between the two groups at 6 months after surgery and at the last follow-up (P > 0.05). At 3 and 6 months after surgery, the Harris scores of hip joint function in the arthroplasty group were significantly higher than those in the fixation group, with statistical significance between the two groups (P<0.05).At 12 months after surgery, there was no significant difference in the Harris score of hip joint function between the two groups (P>0.05).[Conclusion] Both arthroplasty and PFNA internal fixation can achieve satisfactory clinical results in the treatment of intertrochanteric fracture in elderly patients.Strictly grasp the indications when choosing a treatment method in clinic, and a personalized treatment plan is the key to obtain a satisfactory treatment effect in the clinic.