中文摘要：

目的：比较老年骨质疏松性股骨粗隆间骨折半髋置换（HA）与股骨近端防旋髓内钉（PFNA）内固定两种手术方法的临床效果。方法：回顾2009年1月至2013年3月间53例分别接受PFNA和HA手术治疗的年骨质疏松性股骨粗隆间不稳定型骨折。对手术时间、术中出血量、患髋功能及并发症等作比较。结果：随访时间6-18个月，PFNA组骨折全部愈合；手术时间：PFNA组（68±18） min，HA组（96±29） min；术中出血量：PFNA组（104±42） mL，HA组（412±98） mL，Harris评分：PFNA组82.6±13.9，HA组（80.9±12.7），两组均有4例患者出现并发症；两组手术时间、术中失血量有显著性差异（P〈0.05），而并发症发生率、功能评价均无差异（P〉0.05）。结论：对老年骨质疏松性股骨粗隆间骨折病人，PFNA治疗在手术操作上优于HA治疗，但在功能结果没有明显差异。

英文摘要：

Objective To compare the effectiveness of two operative methods of proximal femoral nail antirotation（PFNA） and hemiarthroplasty（HA）in elderly patients with osteoporotic and unstable femoral intertroc-hanteric fractures. Methods： 53 cases of elderly patients with osteoporotic and unstable femoral intertrochanteric fractures treated with PFNA or HA from January 2009 to March 2013 were retrospectively analyzed. Operation duration, blood loss during operation, function of affected hip and complications were compared. Results The patients were followed-up after operation for 6 to 22 months. All fractures treated with PFNA healed. Operation duration： PFNA group（68 ± 18） mins, HA group（96 ± 29） mins; Blood loss during operation： PFNA group（104±42）mL,HA group （412±98）mL;Harris Hip ScorePFNA group 82.6±13.9,HA group 80.9±12.7;There were 4 patients with complications in both PFNA and HA groups. The results showed that PFNA group was less than HA group in operation duration and blood loss during operation （P 〈 0.05）. In hip function outcome and incidence of complication,there were no significant differences between PFNA and HA groups （P〉0.05）.ConclusionFor elderly patients with osteoporotic and unstable femoral intertrochanteric fractures, PFNA was superior to hemiarthroplasty according to the operative statistics, but there were no significant differences in functional outcome.