Abstract:[Objective] To compare the clinical effects of standard cement augmentation of PFNA and femoral head replacement in osteoporotic unstable femoral intertrochanteric fractures. [Methods] Comparative analysis of patients with osteoporotic unstable intertrochanteric fracture treated with cement augmentation of PFNA and femoral head replacement in the Department of trauma surgery of Guangxi Zhuang Autonomous Region People's Hospital from June 2016 to June 2021; There were 42 patients with cement augmentation of PFNA and 57 patients with femoral head replacement. The general data, perioperative related parameters, hip score (Harris score) and pain score (VAS score) of the two groups were compared. [Results] There was no significant difference in age, sex, body mass index and Evans-Jense classification between the two groups (P ≥ 0.05); In the comparison of perioperative related parameters between the two groups, the perioperative blood loss and hospitalization expenses of patients in cement augmentation of PFNA group were significantly lower than those in femoral head replacement group (P ≤ 0.05); There was no significant difference in the operation time and postoperative out of bed time between the two groups (P ≥ 0.05). There was no significant difference in Harris score and VAS score between the two groups (P ≥ 0.05). [Conclusion] In osteoporotic unstable intertrochanteric fractures, the effect of cement augmentation of PFNA on getting out of bed time and hip function after femoral head replacement is the same; However, cement augmentation of PFNA has less bleeding and low hospitalization cost.