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目的:探讨侧卧位无牵引床髓内钉固定在股骨粗隆下骨折治疗中应用的效果。方法:回顾性研究。纳入2015年11月—2018年7月五河县人民医院骨科收治的34例股骨粗隆下骨折患者的临床资料。其中男20例、女14例，年龄23～83(61.7±12.7)岁；SeinsheimerⅡA型5例、ⅡB型4例、ⅡC型7例、ⅢA型3例、ⅢB型5例、Ⅳ型6例、Ⅴ型4例；受伤至手术时间1～12(7.0±1.9)d。患者均在C臂X线机透视下，采用侧卧位无牵引床闭合复位髓内钉固定治疗。记录患者术前体位摆放时间、手术操作时间、术中失血量、术中X线透视次数、骨折复位质量、术后并发症及骨折愈合时间；术后定期随访，记录并比较术后1、6个月及末次随访时髋关节疼痛视觉模拟评分(VAS)、髋关节功能Harris评分，末次随访根据Harris评分评价关节功能。结果:患者体位摆放时间5～11(7.7±1.6)min，手术时间为29～82(60.3±10.9)min，术中失血量为45～350(212.3±57.8)mL，术中透视次数为18～53(33.8±7.3)次。术后即刻摄片，骨折复位质量获解剖复位13例，可接受的复位21例。术后患者切口均一期愈合，未发生感染、深静脉血栓形成、内固定失败。34例患者均获随访，随访时间12～48(22.4±7.7)个月。骨折愈合时间为4～12(5.8±1.7)个月。1例Seinsheimer Ⅳ型患者术后7个月仍未骨愈合，取自体髂骨植骨处理，二次术后3个月愈合。术后1、6个月及末次随访时患者髋关节疼痛VAS评分依次为(4.76±0.96)、(1.91±0.79)和(0.97±0.63)分，Harris评分依次为(74.35±5.83)、(78.79±6.31)和(85.76±6.53)分，差异均有统计学意义(n P值均<0.05)。末次随访髋关节功能优11例、良20例、可2例、差1例，优良率达91.2%。n 结论:侧卧位无牵引床髓内钉固定治疗股骨粗隆下骨折，方法简便、微创，能够取得满意的手术效果，适合在基层医院应用推广。“,”Objective:To explore the effect of lateral recumbent position non-traction bed in the treatment of femoral subtrochanteric fracture with intramedullary nail fixation.Methods:The clinical data of 34 patients with femoral subtrochanteric fractures and who were admitted to the Department of Orthopedics of Wuhe County People's Hospital from November 2015 to July 2018 were retrospectively analyzed, 20 males and 14 females, with average age of 23-83 (61.7±12.7) years old. The cases were Seinsheimer type ⅡA (five cases), type ⅡB (four cases), type ⅡC (seven cases), type ⅢA (three cases), type ⅢB (five cases), type Ⅳ (six cases), and type Ⅴ (four cases). Under the fluoroscopy of the C-arm X-ray machine, the patients were treated with closed reduction and intramedullary nail fixation without traction bed in the lateral recumbent position. The time from injury to operation was 1-12 (7.0±1.9) days. The preoperative posture time, operation time, intraoperative blood loss, X-ray fluoroscopy times, fracture reduction quality, postoperative complications, and fracture healing time were recorded. The hip joint visual analogue scale (VAS) and Harris score at 1 and 6 months and at the last follow-up were recorded and compared. The joint function was evaluated by Harris hip score.Results:The postural time of the patients was 5-11 (7.7±1.6) min. The operation time was 29-82 (60.3±10.9) min. The intraoperative blood loss was 45-350 (212.3±57.8) mL. The fluoroscopy time was 18-53 (33.8±7.3) min. When radiography was performed immediately after the operation, the fracture reduction quality evaluation results showed an anatomic reduction in 13 cases and acceptable reduction in 21 cases. All the incisions healed in one stage after the operation, and no infection, deep venous thrombosis, and failure of internal fixation were observed. All 34 patients were followed up for 12-48 (22.4±7.7) months. One patient with Seinsheimer type Ⅳ still had no bone union at 7 months after the operation. For this case, autogenous iliac bone graft was performed and healed 3 months after the second operation. The fracture healing time was 4-12 (5.8±1.7) months. VAS scores were (4.76±0.96), (1.91±0.79), and (0.97±0.63) points, whereas Harris scores were (74.35±5.83), (78.79±6.31), and (85.76±6.53) points, respectively, at 1 and 6 months after surgery and at the last follow-up. These scores all showed statistically significant differences (all n Pvalues<0.05). At the last follow-up, hip joint function assessment was excellent in 11 cases, good in 20 cases, but good in 2 cases, and poor in 1 cases, with an excellent and good rate of 91.2%.n Conclusions:The method of application of lateral recumbent position non-traction bed in the treatment of femoral subtrochanteric fracture with intramedullary nail fixation is simple, minimally invasive, and can achieve satisfactory results. It is suitable for application and promotion in primary hospitals.