Abstract: [Objective] To compare the clinical efficacy of whether to reconstruct the lateral wall in the treatment of femoral intertrochanteric fractures with proximal femoral nail antirotation(PFNA). [Methods] A retrospective study was done on 60 patients who received surgical treatment for femoral intertrochanteric fracture with fractured lateral wall from January 2017 to June 2021.According to preoperative doctor-patient communication, 31 patients were divided in the reconstruction group and 29 patients in the no reconstruction group .The perioperative, follow-up and radiographic documents were compared between the two groups. [Results] The hip flexion- extension range of motion (ROM), adduction- abduction ROM and Harris score were compared at 1 month, 6 months and last follow-up, each group significantly increased, and the reconstructed group was significantly superior to the unreconstructed group (P <0.05).Radiographically,there was no statistical difference in reduction quality、tip-apex distance(TAD)、neck-shaft angle(NSA) and head-neck shortening in immediate X-ray after surgery between the two groups.For NSA、head-neck shortening and full-weight bearing, the reconstruction group was significantly superior to the unreconstructed group (P <0.05). [Conclusion] Reconstruction of the lateral wall of femoral intertrochanteric fractures have the advantages of early weight bearing, better recovery of hip function and fewer complications.