随着手术技术和内固定材料的发展，股骨转子间骨折的治疗方式不断进步，但是术后内固定失效一直无法避免。对于内固定失效的原因，尚存在争议。目前认为患者高龄、女性和重度骨质疏松使髋部易发生不稳定型骨折，内侧失支撑、股骨颈基底骨折、逆转子间骨折、外侧壁骨折等不稳定型骨折术后内固定位置维持困难，非解剖复位、不合理进钉点、头钉位置不佳，对不稳定型骨折选择髓外固定，以及手术等待时间长、下地负重晚、感染等都可能增加失效风险。因此明确内固定失效的危险因素，并作出相应的处理，从而提高初次手术的成功率，仍是目前治疗的关键。本文拟对股骨转子间骨折术后内固定失效的危险因素进行总结，以期为临床治疗提供一定指导。“,”Advances in surgical techniques and internal fixation materials have been continuously improving treatment of intertrochanteric fractures, but postoperative failure of internal fixation is inevitable and its causes are still controversial. An advanced age, female and severe osteoporosis are believed to lead to an unstable fracture and a fall more likely, increasing the risk for failure of internal fixation. Unstable intertrochanteric fractures such as comminuted fracture of medial femur, basicervical fracture, reverse intertrochanteric fracture and lateral wall fracture are more likely to lead to internal fixation failure. Non-anatomical reduction, improper insertion point and poor position of a lag screw are also prone to internal fixation failure. Extramedullary fixation for unstable fractures may increase the risk of failure. Long waiting time for surgery, late weight-bearing and infection may also increase the risk of failure. Therefore, it is still crucial for a successful treatment to clarify the specific risk factors for internal fixation failure and make corresponding countermeasures to enhance the success rate of a primary operation. This paper summarizes the risk factors for postoperative failure of internal fixation for intertrochanteric fracture so as to provide guidance for clinical treatment.