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目的:探讨具有特定影像学特征的老年股骨转子下骨折闭合复位的手术技巧及临床疗效。方法:回顾性分析2015年1月至2019年12月期间广东省中医院老年骨折科收治的38例具有特定影像学特征的老年股骨转子下骨折患者资料。男14例，女24例；平均年龄为80.9岁（62~95岁）；骨折根据Seinsheimer分型：ⅡB型1例，ⅡC型7例，ⅢA型18例，Ⅳ型9例，Ⅴ型3例。受伤至手术时间平均为2.3 d（0.5~8.0 d）。本组患者的影像学特征包括：①内侧骨折线起点位于较近端，小转子分离；②骨折端内侧短缩重叠，向外成角，呈髋内翻畸形；③牵引后对线恢复正常，仅遗留部分侧方移位。所有患者均通过仰卧位牵引床下闭合复位，复位质量不好者插入主钉或者插入主钉并经螺旋刀片切口通道撬拨复位，再采用股骨近端防旋髓内钉固定。术中根据改良Baumgaertner复位质量评价方法评定骨折复位质量。记录患者的手术时间、术中出血量、骨折愈合时间、患髋功能及并发症发生情况等。结果:本组患者术中骨折复位质量优良率达100%（38/38）。本组患者的手术时间为25~120 min，平均55.6 min；术中出血量为10~150 mL，平均42.9 mL。38例患者术后获10~20个月（平均15.3个月）随访。所有患者骨折均获愈合，愈合时间为3~8个月，平均4.8个月。末次随访时髋关节Harris评分为70~94分，平均81.5分。随访期间无一例患者出现内固定失效、骨折再移位、畸形愈合及骨不连等并发症。结论:具有特定影像学特征的老年股骨转子下骨折，可选择仰卧位牵引床闭合复位髓内钉固定，且临床疗效满意。“,”Objective:To explore the surgical techniques and outcomes of closed reduction for geriatric subtrochanteric femoral fractures with certain radiological characteristics.Methods:A retrospective analysis was conducted in the 38 aged patients with subtrochanteric femoral fracture who had been treated at Department of Geriatric Orthopedics, Guangdong Provincial Hospital of Chinese Medicine from January 2015 to December 2019. There were 24 females and 14 males, aged from 62 to 95 years (average, 80.9 years). According to the Seinsheimer classification, there were one case of type ⅡB, 7 cases of type ⅡC, 18 cases of type ⅢA, 9 cases of type Ⅳ, and 3 cases of type Ⅴ. The time from injury to operation averaged 2.3 days (from 0.5 to 8.0 days). The fractures of this cohort were characterized by: ①The starting point of the medial fracture line was at the proximal end and the lesser trochanter separated. ②The fracture end was shortened and overlapped on the medial side and angled outward, showing a varus deformity. ③The alignment returned to normal after traction, with only partial lateral displacement left. Before fixation with proximal femoral nail antirotation (PFNA), all these patients were treated by closed reduction in a supine traction bed. In those whose reduction was unsatisfactory, a main nail was inserted or after the main nail was inserted reduction by leverage was performed through the screw blade incision. Intraoperatively, the quality of fracture reduction was evaluated according to the modified Baumgaertner assessment. Recorded were the patients’ operation time, intraoperative blood loss, fracture healing time, hip function and complications.Results:All the fractures achieved 100% of good to excellent reduction (38/38). The operation time ranged from 25 to 120 min (average, 55.6 min) and the intraoperative blood loss from 10 to 150 mL (average, 42.9 mL). This cohort of 38 patients was followed for 10 to 20 months (average, 15.3 months). All the fractures united after 3 to 8 months (average, 4.8 months). The Harris hip scores at the last follow-up ranged from 70 to 94 (average, 81.5). The follow-ups revealed no such complications as internal fixation failure, fracture re-displacement, malunion or nonunion.Conclusion:Closed reduction and PFNA fixation in a supine traction bed can lead to satisfactory clinical effects for the subtrochanteric femoral fractures with certain radiological characteristics in the aged patients.