[Objective] To investigate the changes and significance of bone metabolism and inflammatory factor levels in elderly patients with femoral intertrochanteric fractures treated with proximal femoral nail anti-rotation (PFNA). [Methods] 163 elderly patients with femoral intertrochanteric fractures were treated with PFNA, and were divided into the excellent group and the non-excellent group according to the Harris hip function score at 12 months after operation. The bone metabolism and inflammatory factor levels before and after operation were compared, and the relationship between the above indicators and hip function after operation was analyzed. [Results] After 1:1 propensity score matching (nearest principle), the levels of pre-operative procollagen type Ⅰ N-terminal propetide (PINP), the levels of post-operative PINP and interleukin 6 (IL-6) and the difference of IL-6 in the non-excellent group were higher than those in the excellent group, the differences were statistically significant (P<0.05). Logistic regression analysis showed that post-operative drainage, pre-operative PINP and post-operative IL-6 were all independent risk factors for hip function after operation for elderly femoral intertrochanteric fractures (P<0.05). [Conclusion] High levels of pre-operative PINP and post-operative IL-6 are related to hip function after PFNA in elderly patients with femoral intertrochanteric fractures.