ObjectiveTo study the clinical efifcacy and safety in different positions of PFNA for the clinical treatment of intertrochanteric fractures in patients with body mass index>26 kg/m2.Method60 patients with body mass index>26 kg/m2 and intertrochanteric fractures were included. All patients were given PFNA treatment and divided into observation group and control group. Patients in observation group were given lateral position, and patients in control group were given horizontal position. The blood loss, operation time, length of hospital stay, C reactive protein (CRP) and interleukin 6 (IL-6) were compared between the two groups.Result There were no signiifcant differences between the two groups in excellent rates and Harris scores (P>0.05). The blood loss in observation group was less than control group (P<0.05), operative time, incision length in observation group were shorter than control group (P<0.05). There were no signiifcant differences between the two groups in the length of hospital stay, the time to start loading and the time of fracture healing (P>0.05). The CRP, IL-6 levels in observation group were lower than control group (P<0.05). There was no signiifcant difference in the incidence of complications between the two groups (P>0.05).ConclusionThere are good clinical curative effect for lateral position and horizontal position, but lateral position can better surgical site exposure, shorter incision length and operation time, reduce intraoperative blood loss.%目的：探讨不同体位下近端防旋髓内钉（PFNA）内固定术治疗体质指数＞26 kg/m2股骨转子间骨折患者效果，为临床研究提供参考依据。方法选取60例本院股骨转子间骨折且体质指数＞26 kg/m2的患者为研究对象，均采用PFNA内固定术治疗，采用随机数表法将其分为观察组与对照组，术中分别采用侧卧位与平卧位，比较两组患者术中失血量、手术时间、住院时间等。术后采集两组患者静脉血，检测并比较C反应蛋白（CRP）、白细胞介素-6（IL-6）水平。结果两组患者治疗优良率、Harris评分比较差异均无显著性（P＞0.05）。观察组患者术中出血量明显少于对照组（P＜0.05），手术时间、切口长度均明显短于对照组（P＜0.05），两组患者住院时间、术后至开始负重时间及骨折愈合时间比较差异均无显著性（P＞0.05）。观察组患者术后CRP、IL-6水平均明显低于对照组（P＜0.05）。两组患者并发症发生率比较差异无显著性（P＞0.05）。结论对于体质指数＞26 kg/m2的股骨转子间骨折患者，虽然平卧位与侧卧位PFNA治疗均有较好的临床效果，但侧卧位可以更好地暴露手术部位，缩短手术切口长度和手术时间，减少术中出血量。
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