【摘要】 目的 通过设定骨折类型和髓内固定相结合的简易量化评分法，与A0分型进行比较，从而研究老年股骨转子间骨折髓内固定术后失败发生的相关性。方法 回顾性研究分析本院2016年1月至2020年6月符合纳入标准的老年股骨转子间骨折患者225例，随访时间3月至12月，平均4.3月。根据AO分型及简易量化评分法进行分组统计内固定的失败率并进行组内及组间检验。结果 依据AO分型，内固定失败率A1组（5/52）为9.61%,A2.1组（3/36）8.33%,A2.2组（6/66）9.09%,A2.3组（14/50）28.00%,A3组（2/21）9.52%，组内存在差异（P=0.036），行各组间检验，在A1与A2.3组（P=0.022）及A2.2与A2.3组（P=0.012）组间存在差异，其余各组间统计学无显著差异。依据四区评分，内固定失败率4分组100.00%(2/2),5分组68.75%(11/16),6分组22.92%(11/48),7分组3.85%(3/78),8分组6.12%(3/49),9分组0.00%(0/32)，组内存在差异（P<0.001），再行各组间检验，评分5分、6分组间存在差异（P=0.002），评分6分、7分组间存在差异（P=0.002），失败率6分组<5分组、7分组<6分组。7分、8分组间（P=0.675）,7分、9分组间（P=0.555）,8分、9分组间（P=0.274）无显著统计学差异。结论 简易量化评分法中患者分值的高低，与预后存在一定的关联性。股骨转子间骨折随髓内固定后分值在5分，6分，7分及以上时，其分值越高，内固定失败率越低。简易量化评分法相比AO分型，对股骨转子间骨折术后髓内固定预后上具有更好的预测价值。更多还原

【Abstract】 Objective To study the correlation of postoperative failure of femoral intertrochanteric fractures in the elderly by setting a simple quantitative scoring method combining fracture type and intramedullary fixation and comparing with AO classification. Methods From January2016 to June 2020, 225 elderly patients with femoral intertrochanteric fracture were analyzed retrospectively. The mean follow-up time was 4.3 months(range, 3-12 months). According to AO classification and simple quantitative scoring, the failure rate of internal fixation was analyzed by grouping and intra-group and inter-group tests were performed. Results According to AO classification, the failure rate of internal fixation was 9.61% in group A1(5/52), 8.33% in Group A 2.1(3/36), 9.09% in group A2.2(6/66), 28.00% in group A2.3(14/50), 9.52% in group A3(2/21), there were significant differences between the groups of A1 and A2.3(P=0.022) and A2.2 and A2.3(P=0.012), but there were no significant differences among the other groups. The failure rate of internal fixation was 100.00%(2/2) in group 4, 68.75%(11/16) in group 5, 22.92%(11/48) in group 6, 3.85%(3/78) in group 7, 6.12%(3/49) in Group 8, and 0.00%(0/32) in Group 9, there were differences within groups( P=0.000). And the scores of 5 and 6were different between groups(P=0.002), and the scores of 6 and 7 were different between groups(P=0.002), the failure rate of 6-group < 5-group,7-group < 6-group. There was no significant difference between the groups of 7 and 8( P =0.675), 7 and 9(P =0.555), 8 and 9(P =0.274).Conclusion There is a certain correlation between the score of the simplified quantitative scoring system and the prognosis. When the score of femoral intertrochanteric fracture was 5, 6, 7 and above after intramedullary fixation, the higher the score, the lower the failure rate of internal fixation.Compared with AO classification, the simplified quantitative scoring method has better predictive value on the prognosis of intramedullary fixation after in-tertrochanteric fracture of femur.更多还原