Recently, the Department of Orthopedics successfully performed a hemi-hip replacement surgery for a 102-year-old man, who recovered well and was discharged from the hospital. Two months ago, she fell and her family took her to a nearby hospital for emergency treatment. Considering that the old man was 100 years old and combined with coronary heart disease, hypertension and other chronic diseases, the surgery was extremely risky, so the local hospital took conservative treatment such as bed traction and braking. Two months later, the old man’s hip was still painful and difficult to move, and he could not sit up, let alone stand on the ground, and the fracture was found to be obviously misaligned and not healed on the X-ray. The old man’s condition was deteriorating and his spirit was getting worse, so conservative treatment could no longer be maintained; then the 100-year-old man was in bad condition, could he still be operated? For such a fracture, most people choose to perform internal fixation surgery. However, the patient’s osteoporosis is so severe that internal fixation on such a femur is like building a building on sand, which is not solid and the patient cannot stand with weight immediately after surgery. However, the old man is an intertrochanteric fracture, and choosing hemi hip replacement not only requires removal of the femoral head, but also requires repositioning and reconstruction of the fracture displaced large trochanter and other bone blocks, which is significantly more difficult to operate than a simple femoral neck fracture. In addition to the difficulty and risk of the surgery itself, the old man also had coronary heart disease and hypertension, and deep vein thrombosis in the lower extremity was found in the preoperative examination, so the risk of surgery was too great. But can we do without surgery? If surgery is not performed, the old man will not only be unable to stand up, but also likely to have further complications such as pulmonary infection, urinary tract infection and decubitus ulcer, and the deep vein thrombosis already formed, so his life is in danger. In such an advanced and difficult case, after discussion in the general consultation room of the orthopedic department and consultation with multiple departments including internal medicine, anesthesiology, vascular surgery and ICU, and after full communication with the family, it was decided to perform hemi hip arthroplasty. In order to reduce the impact on the general condition of the old man and shorten the operation time, the anesthesiology department adopted nerve block anesthesia which requires high technical requirements. The operation went smoothly and the old man returned to the ward in a conscious state. The post-operative X-ray showed that the artificial femoral prosthesis was satisfactorily positioned and very stable, and the surrounding bone mass was repositioned and fixed. The day after the surgery, the old man was able to stand up with the help of a walker and practice walking. Femoral intertrochanteric fracture is one of the most common fractures in the elderly, and it is also a good site for osteoporotic fractures, once fractured, it will seriously affect the quality of life and even endanger life. Therefore, it is recommended that elderly people pay attention to prevent falls and at the same time actively regulate the prevention of osteoporosis. Once hip fracture occurs, complications such as decubitus ulcer, lung infection and lower limb venous thrombosis caused by fracture should be actively prevented. If conditions allow, surgery should be performed as early as possible to get down to the ground at an early stage with a view to obtaining a better quality of life.