摘要目的:探讨股骨近端防旋髓内钉（PFNA）骨水泥增强内固定治疗老年骨质疏松性股骨转子间骨折的疗效。方法:回顾性分析2012年9月至2018年10月期间贵阳市第四人民医院骨关节外科采用PFNA联合骨水泥增强内固定治疗的52例老年骨质疏松性股骨转子间骨折患者资料。男8例，女44例；年龄为65~91岁，平均78岁。受伤至手术时间平均为4.4 d。骨折AO分型：31-A1.2型1例，31-A2.1型2例，31-A2.2型8例，31-A2.3型34例，31-A3.1型1例，31-A3.3型6例。记录患者的手术时间、术中出血量、住院时间、骨折复位质量、术后负重时间、骨折愈合时间、患髋功能及并发症发生情况等。结果:本组患者的手术时间平均为79.4 min,术中出血量平均为123.6 mL，住院时间平均为11.9 d。术后骨折复位质量根据Francisco评分标准评定：良43例，可接受9例。45例患者术后获5~12个月（平均6个月）随访，7例患者失访。末次随访时根据髋关节Harris评分标准评定疗效：优14例，良25例，可6例，优良率为88.9%（39/45）。随访期间无一例患者发生螺旋刀片松动、切割、断裂及股骨头缺血性坏死等并发症。结论:PFNA联合骨水泥增强内固定治疗老年骨质疏松性股骨转子间骨折可获得较为满意的临床疗效。

abstractsObjective:To investigate the efficacy of proximal femoral nail anti-rotation (PFNA) plus bone cement enhancement in the treatment of geriatric osteoporotic femoral intertrochanteric fractures.Methods:A retrospective analysis was conducted of the 52 elderly patients with osteoporotic femoral intertrochanteric fracture who had been treated at Department of Bone and Joint Surgery, The Fourth People's Hospital of Guiyang from September 2012 to October 2018 by PFNA internal fixation plus bone cement enhancement. They were 8 males and 44 females, aged from 65 to 91 years (average, 78 years). The time from injury to operation averaged 4.4 d. By the AO/OTA classification, there were one case of type 31-A1.2, 2 cases of type 31-A2.1, 8 cases of type 31-A2.2, 34 cases of type 31-A2.3, one case of type 31-A3.1, and 6 cases of type 31-A3.3. The patients' operation time, intraoperative bleeding, hospital stay, fracture reduction, postoperative weight-bearing time, fracture union time, function of the affected hip and complications were recorded.Results:The operation time for this cohort averaged 79.4 min, intraoperative bleeding 123.6 mL, and hospital stay 11.9 d. By the Francisco evaluation, the reduction of intertrochanteric fracture was assessed as good in 43 cases and as fair in 9 cases. Of this cohort, 45 were followed up for 5 to 12 months (average, 6 months) and 7 lost to follow-up. By the Harris hip scores at the last follow-up, 14 cases were rated as excellent, 25 as good and 6 as fair, giving an excellent to good rate of 88.9% (39/45). No complications like loosening, cut-out or breakage of implants or femoral head necrosis occurred during follow-up.Conclusion:In the treatment of geriatric osteoporotic femoral intertrochanteric fractures, PFNA plus bone cement enhancement can achieve satisfactory clinical efficacy.