Abstract: Objective  To investigate the effect of artificial head replacement(FHR) and proximal femoral nail anti rotation(PFNA) in the treatment of elderly patients with intertrochanteric fracture(IFF) with good ability of daily living before injury. 
Methods  A total of 106 elderly patients with better ADL were selected and divided into FHR group(51 cases) and PFNA group(55 cases) according to different treatment methods. The operation time, perioperative blood loss, postoperative ambulation time, hospitalization time, Harris hip score and complications were compared between two groups. 
Results  The perioperative blood loss of FHR group was higher than that of PFNA group, postoperative ambulation time and hospitalization time were shorter than PFNA group, the difference was statistically significant(P＜0.05). There was no significant difference in operation time between two groups(P＞0.05). 12 months after operation, Harris score of hip joint in two groups was higher than that before operation, and Harris score of hip joint in FHR group was higher than that in PFNA group, the difference was statistically significant(P＜0.05). After 12 months of follow-up, the total incidence of postoperative complications in FHR group was lower than that in PFNA group(P＜0.05). 
Conclusion  Compared with PFNA, FHR can significantly reduce postoperative bleeding, shorten postoperative ambulation time and hospitalization time, accelerate hip joint function recovery, and have fewer complications.

Key words: femoral fractures, femoral head replacement, proximal femoral nail anti-rotation