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目的：探讨并总结髋关节置换术与股骨近端内固定系统治疗老年不稳定性转子间骨折的临床疗效，进一步寻求更好的治疗方法。方法选取2008年11月～2012年12月于我院骨科来我院治疗的60例老年不稳定性股骨转子间骨折的患者，随机将患者分为两组，每组30人，试验组使用髋关节置换术的治疗，对照组使用股骨近端内固定术进行治疗。记录并比较两组患者的有效率和满意情况。结果实验组试验组总有效率为93.33%，对照组总有效率为76.67%，实验组和对照组的满意率分别为83.33%、63.33%，两组间的有效率与满意率之间的差异存在统计学的意义（P<0.05)。结论髋关节置换术治疗老年不稳定性股骨转子间骨折较股骨近端内固定术治疗效果好，患者的满意度较高，有很好的临床意义和推广价值。“,”To discuss and summarize the clinical effect of total hip arthroplasty and internal fixation treating on unstable intertrochanteric fracture of the elderly, in order to seek better therapeutic methods. Methods: Choosed 60 patients from Nov.2008 to Dec.2012 to divide into study group and control ed group. Patients in study group were treated with hip arthroplasty and the control ed group were treated with internal fixation, compared the effect and satisfaction of these two groups. Results: The effective rate of study group was 93.33% and the control ed group was 76.67%. The satisfaction of study group was 83.33% and the control ed group was 63.33% (P<0.05). Conclusion: Treating unstable intertrochanteric fracture of the elderly with hip arthroplasty is better than internal fixation,it’s effective to improve the treatment effect and worth to extend in clinic.