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目的分析不同方式处理不稳定型股骨粗隆间骨折(Femoral intertrochanteric fracture，FIF)中小粗隆骨折利弊。方法对小粗隆进行复位固定FIF者32例入观察组，不进行复位固定者42例纳入对照组，对比相关指标。结果观察组手术时间、术中出血量高于对照组，差异具有统计学意义(<0.05)；12个月后观察组髋关节功能评分(87±5)分高于对照组(82±7)分，差异具有统计学意义(<0.05)；观察组术中输血率高于对照组、后遗症发生率低于对照组，差异具有统计学意义(<0.05)。结论对FIF中小粗隆骨折进行内固定处理，有助于改善患者预后，促进术后髋关节功能恢复，但有一定适应证、禁忌症，且可能增加术中创伤、出血风险；老年、合并有其它疾病、手术耐受相对较差者，不应合并处理小粗隆骨折，对于存在内侧皮质缺损等内固定不稳定高危风险因素、耐受较好、术后短期并发症发生风险较低患者，可考虑合并处理小粗隆骨折,但并非必要措施。“,”Objective To analysis the dif erent treatment of unstable femoral intertrochanteric fracture (Femoral intertrochanteric fracture,FIF)the advantages and disadvantages of smal and medium-sized intertrochanteric fracture.Methods The lesser trochanter for reduction and fixation of FIF in 32 cases in the observation group,not for reduction and fixation in 42 cases in the control group,the related index comparison.Results In the observation group,operation time,intraoperative blood loss was higher than the control group,with significant dif erence ( <0.05);observation group 12 months after hip joint function score (87±5)is higher than the control group (82±7),with significant dif erence ( <0.05);the patients in the observation group blood transfusion rate was higher than the control group,the sequela rate is lower than that of the control group,with significant dif erence ( <0.05).Conclusion The FIF smal trochanter fracture treated by internal fixation,help to improve the prognosis of the patients,promote the recovery of hip joint function after operation,but there are some indications,contraindications,and may increase the risk of bleeding in surgery,trauma complicated with other diseases;elderly,tolerance,operation is relatively poor,should not be combined with the treatment of smal intertrochanteric fracture of medial cortical defect,for the existence of the internal fixation of unstable high risk factors,good tolerance,short-term postoperative complications is low risk patients can be considered smal ,combined treatment of intertrochanteric fracture,but not necessary measures.