Abstract: Objective To analyze the effect of Siwu decoction on coagulation function and bone metabolism of senile intertrochanteric fracture patients undergoing proximal femoral anti-rotation nail (PFNA) surgery, and to provide a reference for the clinical treatment of senile intertrochanteric fracture patients. Methods A total of 86 senile patients with intertrochanteric fracture who were diagnosed and inclusion criteria in our hospital were selected from July 2017 to January 2018, and they were randomly divided into observation group (n=43) and control group (n=43) according to the random number table method. The control group was treated with conventional therapy, and the observation group was treated with siwu decoction based on the control group. The fracture healing rate, coagulation function and bone metabolism related indicators levels were compared between the two groups. Results The fracture healing rate in observation group was obviously higher than that of control group (P<0.05). Before treatment, there were no significantly differences in the level of hematocrit value (HCT), hemoglobin (Hb), the hidden blood loss, bone alkaline phosphatase (BALP), osteocalcin (OC) and parathyroid hormone (PTH) and β isomer of the C-terminal telopeptide of type Ⅰ collagen (β-CTX) between the two groups (P>0.05). After treatment, the level of HCT, Hb, BALP and OC were obviously higher than those of before treatment in observation group (P<0.05), and the observation group was obviously higher than the control group (P<0.05). The level of hidden blood loss, PTH and β-CTX were obviously lower than those of before treatment in observation group (P<0.05), and the observation group was obviously lower than the control group (P<0.05). Conclusion The siwu decoction can improve fracture healing rate of patients with intertrochanteric fractures undergoing PFNA surgery, improve coagulation function and promote bone metabolism.