目的探讨闭合复位弹性髓内钉固定治疗大龄儿童股骨转子下骨折的手术技术。方法2004年1月~2006年4月采用上述方法治疗31例年龄9~16岁的股骨转子下骨折患儿,对本组患者的放射学结果、髋关节功能及并发症等资料进行回顾性分析。结果31例骨折均一次愈合,骨折愈合时间为8~16周(平均10.6周),无延迟愈合及骨不连。本组均获18~50个月随访,平均36.2个月,最后一次随访时放射学结果按Theologis标准31例全部为满意;髋关节功能按Sanders标准;优28例,良3例。结论采用弹性髓内钉治疗符合生物学固定原则,并发症少,疗效满意。熟练掌握插钉技术及术中针对不同的骨折特点进行相应的手术操作是防止术后成角畸形的关键。 Objective To investigate the surgical technique of closed reduction and elastic nailing in the treatment of subtrochanteric fractures in older children. Methods From January 2004 to April 2006, 31 children aged 9-16 years old with subtrochanteric fractures were treated by the above method. The radiological findings, hip joint function and complications of the patients were retrospectively analyzed. Results All the 31 fractures were healed one time and the healing time was 8 to 16 weeks (average 10.6 weeks). There was no delayed union and nonunion. The patients were followed up for 18 to 50 months with an average of 36.2 months. The final follow-up radiological findings were satisfactory according to the Theologis standard of 31 cases. The function of the hip joint was evaluated according to the Sanders standard. The results were excellent in 28 cases and good in 3 cases. Conclusion The use of flexible intramedullary nailing in line with the principle of biological fixation, fewer complications, the effect is satisfactory. Proficiency in nail technology and surgery for different fracture characteristics of the corresponding surgical procedures to prevent postoperative angular deformity is the key.