The aim of this study is to compare the effects of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in the treatment of intertrochanteric fractures in order to investigate the significance of internal fixation in the treatment of intertrochanteric fractures in the elderly. One hundred and eight patients admitted with intertrochanteric fractures and treated with PFNA and DHS were retrospectively analyzed. Among the 108 patients, 46 patients were treated with PFNA therapy alone and 62 patients were treated by DHS. The operation time, blood loss, postoperative weight, fracture healing time, incidence of postoperative complications, hip activity, and walking activity were compared, in order to analyze the advantages and disadvantages of the two internal fixation methods. In total, 108 patients were followed up for 9-18 months. There were statistically significant differences in the average operative time, blood loss, fracture healing time, incidence of postoperative complications, and hip function between the two groups (P<0.05); specifically, the outcomes in the PFNA group were better than that in the DHS group. The PFNA method for treating elderly patients with intertrochanteric fractures has the advantages of reasonable design, minimal invasiveness, and reliable fixation, and is an ideal operation method for treating intertrochanteric fractures in elderly patients.