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[目的]探讨股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)结合重建钢板治疗股骨转子下骨折不愈合的临床疗效.[方法] 2006年5月～2015年5月,采用PFNA结合重建钢板治疗股骨转子下骨折不愈合患者15例.男10例,女5例;年龄45～65岁,平均(57.53±6.85)岁.初次致伤原因:交通事故伤8例,摔伤4例,重物砸伤3例.受伤至该次入院前接受手术治疗1次12例,2次3例.骨折距该次入院时间为11～23个月,平均(15.80±3.88)个月.术后定期依据X线片检查以及Harris髋关节功能评分标准评价髋关节功能.[结果]所有患者均顺利接受手术,术后切口均Ⅰ期愈合,均无严重早期并发症.15例均获得随访,随访时间13～42个月,平均(26.27±9.08)个月.X线片示所有患者均达骨性愈合,无畸形愈合,愈合时间10～31周,平均(18.60±5.97)周,无内固定松动或者移位.颈干角由术前(123.53±9.56).增加至末次随访时(134.13±2.70).,差异有统计学意义(P＜0.05).Harris髋关节评分由术前(39.07±14.82)分增加至末次随访时(86.07±7.82)分,差异有统计学意义(P.＜0.05).治疗结果评定为优7例,良6例,可2例,优良率86.67％.[结论]采用PFNA结合重建钢板治疗股骨转子下骨折不愈合,可增加内侧骨皮质的稳定性,避免畸形愈合的发生,临床效果满意.“,”[Objective] To assess the clinical outcomes of proximal femoral nail antirotation (PFNA) combined with reconstruction plate for subtrochanteric fracture nonunion.[Methods] From May 2006 to May 2015,15 patients with subtrochanteric fracture nonunion were surgically revised with PFNA plus reconstruction plate.Of them,there were 10 males and 5 females aged from 45 to 65 years with a mean of (57.53±6.85) years.The original injury mechanism was recorded traffic accident in 8,falling in 4,and heavy crush in 3case.Twelve patients had received once operation,while the remaining 3 patients had twice surgery before this hospitalization,with (15.80±3.88) months (range,11～ 23 months) elapsed from the first operation to this time.After the revision surgery,the patients were give interviews and X-ray check regularly.[Results] All the patients had operation performed smoothly with the incisions healed well without serious early complication.All of them were followed up for an average of (26.27±9.08) months (range,13～42months).Radiographic examination showed that all the patients got bony healing between 10 and 31 weeks with a mean of (18.60±5.97) weeks,without implant loosening or breaking in anyone of them.The neck shaft angle significantly increased from (123.53±9.56)° preoperatively to (134.13±2.70)° at the latest follow up (P＜0.05).In addition,the Harris score considerably improved from (39.07±14.82) before operation to (86.07±7.82) at the final interview.As result,the clinical outcomes were graded as the excellent in 7,good in 6,and fair in 2 patients,associated with an excelleut and good rate of 86.67％.[Conclusion] The PFNA combined with reconstruction plate does get satisfactory clinical consequences for subtrochanteric fracture nonunion,because it effectively increase the stability of medial cortical reconstruction to avoid the occurrence of deformity.