(Disclaimer: This article is only for the purpose of popularization of science, in order to protect the patient’s privacy, the relevant information in the following content has been processed) Abstract: 75 years old female patient in the middle of the thigh deformity after traumatic injuries, the length of the affected limb is shortened, the existence of local abnormal activity, X-ray filming basically confirmed femoral stem fracture. It is recommended to hospitalize the patient to take incision reduction titanium plate screw internal fixation surgical treatment, after standardized treatment, the patient’s fracture broken end alignment alignment basically recovered, the whole body muscle strength gradually recovered, the lower limb weight-bearing walking function gradually recovered. Basic information] Female, 75 years old [Disease type] Femoral stem fracture [Hospital] The First Hospital of Harbin [Time of consultation] March 2021 [Treatment plan] Surgical treatment (incision and repositioning titanium plate screw internal fixation) + postoperative rehabilitation training [Treatment cycle] Hospitalization for 7 days, outpatient follow-up for 3 months [Treatment effect] The patient’s whole body muscle strength gradually recovered, and the affected limb can be loaded to walk I. First visit Interview The patient is a 75-year-old woman with a mid-thigh deformity, shortened length of the affected limb, and abnormal local activities after a traumatic injury. The femoral stem fracture was basically confirmed by taking a front and side X-ray of the femoral stem. Due to the poor stability of the fracture site, the fracture end could not be stabilized by traction treatment of the lower limb, and it was suggested to carry out internal fixation treatment with titanium plate screws for incision and reduction to restore the force line of the lower limb and the stability of the fracture end, to ensure the fracture site healing smoothly, and also to enable the patient to leave the bed as soon as possible, to avoid the occurrence of bed-ridden complications such as bedsore, etc., so the patient and his family agreed to carry out the treatment of internal fixation. During the operation, it was found that the fracture end of femoral stem was significantly dislocated, and there were soft tissues embedded in the fracture end such as muscle, which prevented the fracture end from being aligned. After removing the soft tissues, the fracture end was reset and fixed, and the fracture end was stabilized, and the operation was finished after confirming the stability of the fracture end. After the operation, ice packs were applied locally to eliminate swelling and relieve pain, and patients were encouraged to start knee flexion and extension activities to accelerate blood circulation in the lower limbs, prevent deep vein thrombosis in the lower limbs, and promote the recovery of blood supply to the fractured ends and promote fracture healing. The patient was discharged from the hospital 7 days after titanium plate screw internal fixation surgery for femoral stem fracture with significant reduction of local pain symptoms in the thigh, complete removal of limb shortening deformity and abnormal activities, and completion of flexion and extension activities of lower limb joints; the patient could turn over on his/her own in bed, and he/she could stand and move away from the bed without loading under the protection of the walker, and then the patient was discharged from the hospital. After rehabilitation training, the patient’s gastrointestinal peristalsis activity was restored to the normal level, appetite was improved, and nutritional status was enhanced. After 3 months of outpatient follow-up and standardized rehabilitation training, the patient’s whole body muscle strength gradually recovered, and the affected limbs could walk with weight bearing. Precautions We are glad that the patient can resume walking, but we still need to advise the patient to continue to adhere to the functional exercise to ensure that the local swelling of the thigh subsides completely, and we should also pay attention to observing whether there is any sudden pain in the lower limbs. If there are any abnormal symptoms, the patient should go to the orthopedic clinic in time to review the vascular ultrasound of the lower limbs and the D-dimer and other indexes, so as to detect deep vein thrombosis of the lower limbs in time. Before the fracture of the femoral stem completely heals, avoid weight-bearing walking of the affected limb for a long time to prevent delayed healing of the fracture or non-healing of the fracture, which may affect the functional recovery of the lower limb. The patient suffered from femoral stem fracture under the action of violence, and the displacement of the fracture ends was obvious, conservative treatment could not meet the needs of recovery, and the surgical incision and reduction of titanium plate screw internal fixation could ensure the fracture ends were in the right position and in the right line. After the operation, attention should be paid to the deep vein thrombosis of the lower limbs and bedsores and other complications to strengthen the nursing care. In daily life, patients should pay attention to strengthen the leg muscle exercise, improve the stability of the lower limb bone joints, enhance the bone mineral density, and should pay attention to prevent accidents from occurring, avoiding to lead to femoral stem fracture.