目的：通过应用TITAN及PFNA内固定系统治疗A1型老年股骨粗隆间骨折，分别观察两种内固定系统术后的治疗效果及并发症发生情况，为治疗A1型老年股骨粗隆间骨折的临床疗效提供参考依据。

方法：本研究选取2018年9月至2021年12月期间于我院行股骨粗隆间骨折闭合复位TITAN或PFNA内固定系统治疗。根据纳入及排除标准共筛选出患者56例，其中选用TITAN治疗的患者共26例，选用PFNA治疗的患者共30例，分析比较两组患者的手术时间、术中出血量、术中透视次数、术后连续3天血红蛋白变量、术后非负重下地时间、骨折愈合时间及术后并发症发生率等方面。患者出院后对其随访至少1年，对比两组患者术后1周、1个月、3个月VAS评分及术后1个月、3个月、6个月、12个月髋关节Harris评分，将得到的数据整理应用SPSS27.0统计学软件进行统计学分析。

结果：56名患者均得到随访，平均14.80±0.47个月（13-16个月）。对患者术前一般资料统计学分析，两组患者在性别、致伤因素、受伤部位及年龄比较中，p＞0.05，差异无统计学意义；对患者临床资料进行统计学分析，两组术前血红蛋白测定值及术前VAS评分比较中，p＞0.05，差异无统计学意义；在手术时间、术中出血量及术中透视次数比较中，p＜0.05，差异具有统计学意义；手术后持续3天的血红蛋白测定值对比p＜0.05，差异有统计学意义；手术后住院治疗时间对比p＞0.05，差别无统计学意义；手术后非负重下地时间、在术后负重下地时间与骨折愈合时间的对比上，均表现为p＜0.05，差异有统计学意义；手术后1周的VAS评分对比，其中p＜0.05，差异有统计学意义；手术后1个月和3个月的VAS评分对比p＞0.05，差别无统计学意义；两组患者在手术后1个月和3个月的Harris评分对比p＜0.05，差异有统计学意义，术后6个月和12个月Harris评分对比p＞0.05，差别无统计学意义；在对病人的手术后并发症进行统计时，其结果为p＜0.05，差异有统计学意义。

结论：TITAN与PFNA髓内固定系统对于治疗A1型老年股骨粗隆间骨折来说，都能取得较好的疗效；但TITAN髓内固定系统在治疗A1型老年股骨粗隆间骨折有着可以早期安全的进行功能锻炼、降低术后并发症、加快骨折愈合、改善患者术后生活质量的优势。

Objective: To observe intertrochanteric fracture of femur type A1 was treated with TITAN and PFNA internal fixation system. The curative effect and complication of intertrochanteric fracture of femur type A1.

Method: Intertrochanteric fractures of the femur were treated with the TITAN or PFNA internal fixation system between September 2018 and December 2021 at Yanbian University Hospital. A total of 56 patients were selected based on inclusion and exclusion criteria, including 26 patients who were treated with TITAN and 30 patients who were treated with PFNA. The time of surgery, intraoperative haemorrhage, number of intraoperative x-rays, hemoglobin variables for 3 consecutive days, time of non-weight-bearing drop, time of fracture healing and incidence of postoperative complications were analyzed and compared between the two groups. Patients were followed up for at least 1 year after discharge and compared with 1 week, 1 month, 3 months of VAS scores and 1 month, 3 months, 6 months, 12 months of hip Harris scores in both groups. The data collected were statistically analyzed using SPSS 27.0 statistical software.

Results: All 56 patients were followed up for an average of 14.80 ± 0.47 months (13-16 months). In a statistical analysis of the patients' general pre-operative data, p > 0.05 was found between the two groups in terms of sex, injury factors and injury site. The clinical data of the patients were analyzed statistically and the difference between the two groups was not statistically significant in comparison of preoperative hemoglobin values and preoperative VAS scores, p > 0.05. The difference was statistically significant in time of surgery, intraoperative haemorrhage and number of intraoperative x-rays, p < 0.05. The difference was statistically significant in hemoglobin measurements that lasted three days after surgery, p < 0.05. The difference was statistically significant in postoperative hospitalization time, post-operative time without negative weight, post-operative time without negative weight and post-operative time with fracture healing time, all patients showed a statistically significant difference of p < 0.05, while the difference in VAS scores was statistically significant in one week after surgery and three months after surgery, respectively.

Conclusion: TITAN and PFNA intramedullary fixation system were effective in the treatment of intertrochanteric femoral fractures. TITAN intramedullary fixation system has the advantages of early and safe functional exercise, faster fracture healing and better quality of life after surgery in the treatment of A1 aged intertrochanteric femoral fractures.

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