Nailing or joint replacement? My mother is 75 years old, usually has high blood pressure and is in good health. The morning before yesterday she was exercising in the neighborhood and fell on the way back, and came home feeling pain in the area of her hip bone. I took her to the hospital for a checkup, took x-rays and CT, and to my surprise, it was a fracture in the hip joint! The doctor said, “Fortunately, the fracture is not very serious. The doctor said that the fracture was not very serious, and that she could have a joint replacement or a “nail”. 1. Why did my mother fracture her bone after just one fall? The decline in muscle flexibility, joint flexibility and coordination make the elderly more prone to falls, and the decline in self-protection makes the elderly fall more “solid”. The main reason for hip fracture after a fall is osteoporosis, the hardness of the bone decreases, the brittleness increases, and the hip is one of the main weight-bearing parts of the lower limbs, prone to osteoporotic fractures. 2.What does the doctor mean by “nailing”? Will this treatment cause any problems in the future? By “nailing”, doctors mean fixing the fracture with internal fixation materials (mostly titanium plates and screws) to maintain the normal position of the fracture and provide conditions for fracture healing. Hip fractures are divided into two main categories according to the fracture site, namely, trochanteric fractures and femoral neck fractures, and trochanteric fractures are mostly treated with internal fixation after fracture repositioning due to the rich local blood supply, while femoral neck fractures may cause damage to the blood supply of the femoral head, resulting in traumatic ischemic necrosis of the femoral head, causing loss of hip function and physical disability. Hip replacement surgery can be performed directly on these patients. However, not all patients with femoral neck fractures need hip replacement surgery. For patients with femoral neck fractures that are not obviously displaced and have relatively small damage to the blood supply of the femoral head, internal fixation surgery can still be used and the chance of ischemic necrosis of the femoral head after surgery is relatively small; while for femoral neck fractures that are obviously displaced and have relatively large damage to the blood supply of the femoral head, the risk of ischemic necrosis of the femoral head after internal fixation surgery is relatively high. risk is relatively high, it is suitable for direct hip replacement surgery; for serious hip diseases existing before the injury, such as hip osteoarthritis, etc., direct hip replacement surgery can also be used to treat both the original disease and the femoral neck fracture; if the patient is combined with serious osteoporosis, considering that the bone condition cannot hold the screw, direct hip replacement surgery can also be considered. Possible complications related to hip fracture after internal fixation surgery include non-union of fracture, loosening of internal fixation, ischemic necrosis of femoral head, deep vein thrombosis of lower extremity and deep infection, etc. 3. What is the approximate cost of joint replacement? How long will the replacement joint last? Will it cause any complications? Depending on the general condition of the body before the injury, the mobility and the expected life expectancy, a 75-year-old person can choose a hemi- or total hip replacement surgery, and can choose a cemented or biologically fixed prosthesis depending on the bone quality. Generally speaking, the productivity of the prosthesis 10 years after hip replacement surgery is over 95%. Complications of hip surgery include dislocation, loosening of the joint, infection, deep vein thrombosis, etc. 4. I always feel that it is best to use my own joint. So, in my mother’s case, can she be “pinned”? If it is a fracture of the trochanter, internal fixation can be used; if it is a fracture of the femoral neck without displacement, internal fixation can be used; if it is a fracture of the femoral neck with obvious displacement, hip replacement surgery is recommended. 5. What should she pay attention to after the surgery? How long will it take to recover? After surgery, the doctor will make a rehabilitation plan according to the actual situation of the surgery, and the patient needs to cooperate with the doctor’s suggestion for rehabilitation and regular review.