Abstract: Objective To compare the outcomes of Asian proximal femoral intramedullary nail anti-rotation （PFNAⅡ） with and without using guide wire and reaming for the treatment of elderly osteoporosis intertrochanteric fractures. Methods From January 2010 to March 2014, 60 elderly patients with osteoporosis intertrochanteirc fractures were treated with PFNA Ⅱ. They were randomly divided into group A and group B （n=30）. In group A, guide wire and reaming were used before inserting the nail, while not used in group B. The operation time, intraoperative blood loss, pre-and post-operative hemoglobin, X-ray exposure times and postoperative outcomes between the two groups were compared. Results The average operation time of group A was 50.5 min （40.5-80 min）, average intraoperative blood loss was 75 mL （45-120 mL）, average pre-operative hemoglobin was 95 g/L （84-120 g/L）, and 85 g/L （55-115 g/L） post-operative. 2 patients accepted concentrated red blood cells transfusion of 2 units for blood loss. The average operation time of group B was 39 min （30-50 min）, average intraoperative blood loss was 35 ml （30-55 mL） with no post-operative blood transfusion, average pre-operative hemoglobin was 95.3 g/L （80-125 g/L）, and 85 g/L （75-120 g/L） post-operation. No patients received blood transfusion. X-ray exposure times in group B was 3 times less than in group A for each patient on average. All the patients were followed up for 3-12 months （mean, 9 months）. The Harris hip score was 84.5 （70-93） in group A and 89.5 （80.5-95） in group B. No varus hip deformities, screw cutouts, femoral shaft fractures or failure of internal fixation were observed. Conclusion When PFNAⅡis used to treat osteoporosis interonchanteric fractures of elderly patients, comparing with using guide wire and reaming, not using guide wire and reaming has the advantages of shorter operation time, less intraoperative and post-operative blood loss, and better results.

Key words: Femur, Intertronchanteric fracture, Proximal femoral intramedullary nail anti-rotation, Internal fixation