An 88-year-old man with a femoral neck fracture successfully replaced his hip joint and was discharged from the hospital 3 days after surgery; a 90-year-old man who underwent arthroscopic cleaning of both knees at the same time, recovered satisfactorily after surgery, dispensed with artificial joint replacement, and life continued in motion; a 70-year-old man who was afraid of surgery because of a fracture between the femoral ramus and chose Chinese medicine to reset and fix it, and was eventually discharged from the bed due to the history of thrombosis, the above cases are real, so how should people properly face How should people properly face the risk of orthopedic surgery for the elderly? In fact, surgery for the elderly itself is not particularly difficult, mainly because the elderly are frail and sickly, which can bring certain risks to surgical anesthesia and for perioperative management, and can easily endanger lives due to complications. Due to osteoporosis and reduced bone strength, common fracture sites in the elderly are the hip (intertrochanteric fracture and femoral neck fracture) and wrist fractures. Wrist fractures are relatively simple, while hip fractures have a greater impact on life and livelihood and require surgical treatment. The choice of surgical plan after fracture in the elderly should be based on the principles of less trauma, shorter operation time and less disturbance to the organism’s blow, and to achieve reliable results and the ability to move down to the ground early. Minimally invasive surgery such as closed reduction, external fixation frame fixation or intramedullary fixation for femoral ramus fracture has the advantages of no incision, less bleeding and short operation time, which is suitable for elderly patients; artificial femoral head replacement for femoral neck fracture can be done after surgery, which can reduce complications. For lumbar compression fractures, percutaneous vertebral body ballooning can be performed under local anesthesia, and early postoperative activities can be performed on the ground under the protection of braces. Issues that should be noted in the perioperative period include: a functional examination of all organs of the body before surgery, a detailed understanding of the reserve situation, and active treatment of other diseases. Diabetic patients should have their blood sugar controlled, and hypertensive patients should have their blood pressure lowered. After surgery, vital signs should be monitored at all times, blood indicators should be checked, anticoagulants should be applied to prevent thrombosis, and patients should be encouraged to move off the floor early to prevent complications.