【摘要】 目的探讨接受InterTan内固定术的老年股骨转子间骨折患者发生骨折不愈合的危险因素。方法回顾性分析2018年2月至2022年2月于河北大学附属医院接受InterTan内固定术治疗的214例年龄≥65岁的股骨转子间骨折患者。研究其性别、骨折原因、外侧壁完整性、螺钉位置、Garden对线指数、是否合并骨质疏松、骨折类型及下地负重时间等对骨折不愈合的影响。结果患者中197例骨折完全愈合，17例发生骨折不愈合，骨折不愈合发生率为7.9%。单因素分析表明，性别和骨折原因对骨折不愈合的概率无显著影响，差异无统计学意义（P>0.05）。Logistic回归分析进一步指出：外侧壁不完整、螺钉位置不当、Garden对线指数不理想、骨折不稳定及骨质疏松是导致骨折不愈合的主要原因，而术后6周以后下地负重是骨折不愈合的保护因素。结论股骨转子间骨折InterTan内固定术后骨折不愈合受到多因素的综合影响，包括外侧壁完整性、螺钉位置、Garden对线指数、骨折疏松、骨折类型及下地负重时间，为了提高治疗效果，应该准确把握并预防这些风险因素。更多还原

【Abstract】 Objective To investigate the causes of fracture nonunion in patients with intertrochanteric fractures treated with Inter Tan internal fixation. Methods A retrospective analysis of 214 patients with intertrochanteric fractures older than 65years who received InterTan internal fixation in the Affiliated Hospital of Hebei University from February 2018 to February 2022. Factors influencing fracture non-union, including gender, fracture aetiology, stability, lateral wall integrity, screw position, Garden alignment index, presence of osteoporosis, and time to weight-bearing after surgery, were examined.Results Fracture healing was achieved in 197 cases, and 17 cases developed nonunion, with a nonunion rate of 7.9%.Univariate analysis showed that gender and injury aetiology did not significantly affect the likelihood of nonunion, with no significant difference(P>0.05). However, factors such as fracture stability, integrity of the lateral wall, screw position,Garden alignment index, presence of osteoporosis, and time to weight bearing after surgery had an impact on the incidence of nonunion, with significant differences(P<0.05). Logistic regression analysis further indicated that factors leading to nonunion included unstable fractures, incomplete lateral wall, improper screw position, unsatisfactory Garden alignment index, and osteoporosis. Postoperative weight bearing after 6 weeks was a protective factor against nonunion. Conclusion Fracture nonunion after Inter Tan internal fixation of intertrochanteric femoral fractures is influenced by multiple factors,including fracture type, patient bone status, surgical approach, and postoperative rehabilitation training. To improve the treatment outcomes, these risk factors should be accurately identified and prevented.更多还原