Abstract: Objective　To explore the effect of anti-rotation proximal femoral intramedullary nail (PFNA) in the treatment of elderly patients with unstable intertrochanteric fracture of femur (IFF) and its effect on the functional recovery of hip joint. Methods　A total of 94 elderly patients with unstable IFF treated at Department of Orthopedics, Yellow River Central Hospital from October 2018 to October 2020 were selected as the research objects. They were divided into a conventional group and a PFNA group by the random number table method. There were 47 cases in the conventional group, including 27 males and 20 females, with an age of (79.00±3.27). There were 47 cases in the PFNA group, including 28 males and 19 females, with an age of (78.00±3.35). The conventional group were treated by hemiarthroplasty, and the PFNA group by PFNA. The operative indicators, hip function, and complications of the two groups were compared. The relevant statistical data were analyzed by independent-sample t test and Chi-square test. Results　There was no difference in the fracture healing time between the PFNA group and the conventional group [(14.00±2.71) weeks vs. (13.00±2.62) weeks; t=1.818 8, P=0.072 2]. The intraoperative blood loss, bed time, operation time, incision length, postoperative weight-bearing standing time in the PFNA group were better than those in the conventional group [(122.03±16.23) ml vs. (132.05±18.76) ml, (2.00±1.34) d vs. (5.00±1.51) d, (51.00±5.38) min vs. (62.00±6.05) min, (7.21±1.62) cm vs. (11.49±2.27) cm, (23.00±3.18) d vs. (15.00±2.61) d], with statistical differences (all P<0.05). The excellent and good rate of hip function in the PFNA group was higher than that in  the conventional group [91.49% (43/47) vs. 80.85% (38/47)], with no statistical difference (χ²=2.231 7, P=0.135 2). The incidence of complications in the PFNA group was lower than that in the  conventional group [8.51% (4/47) vs. 14.89% (7/47)], with no statistical difference (χ²=0.926 6, P=0.335 7). Conclusions　For patients with serious fracture and osteoporosis, no serious medical diseases, and relatively good body quality, hemiarthroplasty is used, but it may cause deep vein thrombosis and wound infection, etc. For patients with mild osteoporosis, more medical diseases, and low body quality, PFNA should be used, but it may cause varus of the hip and femur head cutting, so premature weight-bearing activities should be avoided and anti-osteoporosis treatment should be carried out in time.

Key words: Anti-rotation proximal femoral intramedullary nail, Intertrochanteric fracture of femur, Hip function

摘要： 目的　探索防旋型股骨近端髓内钉（PFNA）治疗高龄不稳定型股骨粗隆间骨折（IFF）患者的效果及其对髋关节功能恢复的影响。方法　选取黄河中心医院骨科2018年10月至2020年10月收治的94例高龄不稳定型IFF患者作为研究对象，随机数字表法分为常规组和PFNA组。常规组47例，男27例，女20例，年龄（79.00±3.27）岁；PFNA组47例，男28例，女19例，年龄（78.00±3.35）岁。常规组给予半髋关节置换术治疗，PFNA组给予PFNA治疗。对比两组手术相关指标、髋关节功能、并发症，应用独立样本t检验和卡方检验对相关统计学数据进行分析。结果　PFNA组骨折愈合时间（14.00±2.71）周，常规组（13.00±2.62）周，差异无统计学意义（t=1.818 8，P=0.072 2）；PFNA组术中出血量、卧床时间、手术时间、切口长度均低于常规组［（122.03±16.23）ml比（132.05±18.76）ml、（2.00±1.34）d比（5.00±1.51）d、（51.00±5.38）min比（62.00±6.05）min、（7.21±1.62）cm比（11.49±2.27）cm］，术后开始负重站立时间长于常规组［（23.00±3.18）d比（15.00±2.61）d］，差异均有统计学意义（均P＜0.05）。PFNA组髋关节功能优良率91.49%（43/47），高于常规组的80.85%（38/47），但差异无统计学意义（χ²=2.231 7，P=0.135 2）。PFNA组并发症发生率8.51%（4/47），低于常规组的14.89%（7/47），但差异无统计学意义（χ²=0.926 6，P=0.335 7）。结论　对于骨质疏松状态较为严重、不存在严重内科疾病、自身机体素质相对良好的患者，选用半髋关节置换术，但可能引起深静脉血栓、伤口感染等；对于骨质疏松状态较轻、存在较多内科疾病、自身机体素质低下的患者，选用PFNA，但可能引起髋内翻、股骨头切割等，应避免过早负重活动，及时进行抗骨质疏松治疗。

关键词: 防旋型股骨近端髓内钉, 股骨粗隆间骨折, 髋关节功能