Abstract：Objective: To analyze the efficacy and biomechanical properties of proximal femoral locking plate (LPFP) and proximal femoral anti-rotating intramedullary nail (PFNA) in the treatment of intertrochanteric fracture in elderly patients.Methods: 106 elderly patients with intertrochanteric fracture of femur in our hospital were randomly divided into LPFP group (53 cases) and PFNA group (53 cases). After treatment intervention, the operation time, intraoperative bleeding volume, weight-bearing time, fracture healing time and Harris hip function score of 9 months after operation in the two groups were counted. The complications after operation in the two groups were analyzed. At the same time, 10 fresh old femoral specimens were selected to prepare the model of intertrochanteric fracture of femur in the elderly. They were randomly divided into PFNA group and LPFP group with 5 in each group. After treatment and intervention, axial compression test, destructive load test and torsional stiffness test were carried out by mechanical testing machine, and biomechanical properties were recorded.Results: The average operation time, weight-bearing time and fracture healing time in PFNA group were shorter than those in LPFP group (P < 0.05), and the average intraoperative bleeding volume in PFNA group was less than that in LPFP group (P < 0.05), and the average Harris score was higher than that in LPFP group (P < 0.05). The total incidence of postoperative complications in PFNA group and LPFP group was 7.56% and 18.87% respectively. There was a significant difference between the two groups (P < 0.05). After intervention of fracture model treatment, the average values of axial compression and damage load in PFNA group were higher than those in LPFP group (P < 0.05), and the average values of torsional stiffness in PFNA group were lower than those in LPFP group (P < 0.05). Conclusion：Compared with LPFP, PFNA has less trauma in the treatment of intertrochanteric femoral fractures in the elderly. With its good biomechanical properties, PFNA can effectively promote fracture healing and hip function recovery, and significantly reduce the incidence of hip varus, screw loosening and cutting complications.