关键词: 股骨粗隆间骨折, 解剖型锁定钢板, 股骨近端防旋髓内钉

Abstract: Objective：To investigate the efficacy of proximal femoral nail anti rotation intramedullary nail（PFNA）and anatomic locking plate（ALP）in the treatment of intertrochanteric fracture in elderly patients.Methods：A retrospective analysis of 140 cases of patients with femoral instability since January 2012～2014 year in May were intertrochanteric fracture，internal fixation according to different methods，they were divided into PFNA group（PFNA internal fixation，62 cases）and ALP group（ALP internal fixation，78 cases）.The perioperative indicators of the two groups were compared and the effects and complications were observed and compared.Results：Two groups of patients were successfully completed the operation，did not appear in the accident.There were 6 cases of pulmonary infection after operation（2 cases of group PFNA，4 cases in group ALP），4 cases of lower limb vein thrombosis（2 cases in each group），all of which were cured after symptomatic treatment.Perioperative index comparison，the operation time of group PFNA were significantly less than group ALP，the amount of bleeding was significantly lower than that of group ALP，incision length was significantly shorter than the group ALP，there were significant differences（P<0.05）.Group PFNA of patients after the tip apex distance was significantly shorter than the group ALP patients（P<0.05）；but the two groups the collodiaphyseal angle of comparison，the difference was not statistically significant（P>0.05）.All the two groups were followed up for 16～24 months.Comparison of postoperative recovery，the patients in the group PFNA load time and fracture healing time were significantly shorter than the group ALP（P<0.05）；the time of followup，group ALP of 2 cases of hip varus deformity，4 cases of femoral neck cut；a case of fracture fixation or loosening，femoral neck cut and coxa vara complication there was not happened in the group PFNA.According to the Harris score at 6 〖LM〗months after operation，the efficacy of the two groups，the excellent rate of group PFNA was 93.5%，and there was no significant difference with the group ALP（92.3%）（P>0.05）.Conclusion：In the treatment of femoral intertrochanteric fracture with internal fixation，PFNA has less trauma，less bleeding，firm fixation，more conducive to fracture healing and early weight bearing exercise.But in the overall efficacy，PFNA and ALP can achieve good results in clinical applications，according to the actual situation of patients with fracture，as appropriate，to choose the appropriate treatment method.

Key words: intertrochanteric fracture, anatomical locking plate, proximal femoral nail anti rotation intramedullary nail