目標：本研究探討60歲（含）以上老年人發生髖部骨折後，接受金屬內固定術或人工髖關節置換術治療後，於二年內發生失敗機率的比較。方法：運用國家衛生研究院2004年至2008年全民健保資料庫進行分析，並以SPSS17.0進行描述性統計、t檢定及邏輯斯迴歸分析。結果：2004年至2008年發生股骨頸、股骨轉子間、股骨轉子下及整個髖部骨折且住院的人數分別為40,051、35,130、2,767及77,948人；經排除手術後兩年內退保或死亡者及未手術者後，其接受金屬內固定術的失敗率分別為11.6%、6.5%、13.7%及8.0%；人工髖關節置換術的手術失敗率則分別為3.8%、6.4%、4.8%及3.9%，影響髖部骨折手術失敗風險因素有性別、年齡別、疾病共病症、骨折部位及醫院等級等。結論：不管是股骨頸、股骨轉子間、股骨轉子下或是整個髖部骨折的病人其接受金屬內固定術的失敗率皆比接受髖關節置換術的病人為高。

Objectives: This study explored the failure rates of internal metal fixation surgery and artificial hip replacement in older adults who underwent either surgery (age ≥60 y) within 2 years of a hip fracture. Methods: Data from 2004 to 2008 were obtained from the National Health Insurance Research Database of Taiwan for an analysis. SPSS Version 17 was used to conduct a descriptive statistical analysis, t test, and logistic regression analysis. Results: The number of inpatients experiencing fracture in the femoral neck, intertrochanteric bone, subtrochanteric bone, and the overall hip were 40,051, 35,130, 2,767, and 77,948, respectively. After the patients who withdrew from the National Health Insurance program or died within 2 years of surgery and unreceived hip surgery were excluded, the failure rates for patients who underwent internal metal fixation surgery due to a femoral neck fracture, intertrochanteric fracture, or subtrochanteric fracture, or all hip fractures were 11.6%, 6.5%, 13.7%, and 8.0%, respectively. The corresponding failure rates for patients who underwent an artificial hip replacement were 3.8%, 6.4%, 4.8%, and 3.9%. Factors influencing the failure risk of hip fracture surgery included sex, age, comorbidity status, fracture position, and hospital level. Conclusions: Regardless of the fracture position of hip, patients who underwent internal metal fixation surgery exhibited higher failure rates compared with patients who underwent an artificial hip replacement.