As the saying goes, “three parts treatment, seven parts care”. It can be seen that treatment and care are inseparable, and functional exercise is the most important part of orthopedic care. Preoperative psychological care of this disease is common in the elderly, most usually healthy, due to sudden accidents, resulting in lower limb activity disorders, life can not take care of themselves, resulting in anxiety and depression and fear, some worry about becoming disabled after surgery, to the family and loved ones to bring the burden of the lack of confidence in surgical treatment. Depression after hip fracture is an obstacle to fracture recovery. For patients with different psychological characteristics, experience, cultural qualities, living habits, professional hobbies, take different ways of conversation, patiently explain to the patient about the medical knowledge and treatment technology rehabilitation care and advanced equipment, and please the surgery after the effect of good, fast recovery patients to introduce the personal experience, to understand the process of the surgery and the effect of the surgery, to relieve their psychological pressure and concerns, actively cooperate with the treatment, and establish the confidence of overcoming the pain. The patients will be asked to introduce their experiences to understand the process and effect of the surgery, relieve their psychological pressure and worries, actively cooperate with the treatment and establish confidence in overcoming the pain. Prognosis and rehabilitation care Disease observation Surgery is usually performed under general anesthesia or epidural anesthesia. After the operation, after returning to the ward, go to the pillow and lie down with the head tilted to one side for 6h, routinely measure the body temperature, pulse, respiration, blood pressure, if the patient complains of chest tightness and panic, and at the same time there is an increase in the pulse rate, pallor, and cold sweating, even if the blood pressure is normal, we should also pay attention to whether there is any sign of early shock. At the same time, actively do a good job of opening the peripheral veins, oxygen inhalation and the preparation of emergency drugs. Skin traction care patients return to the ward that is skin traction 1 ~ 2 weeks, weight 3kg, excessive easy to cause dislocation, to maintain the abduction of the neutral position, the crescent fossa part of the pad soft pillows, so that the knee flexion 15 ° or so. In addition to pay attention to the direction of traction, angle, weight, should pay special attention to the activities of the affected limbs, feeling, such as toe dorsiflexion muscle strength or the dorsum of the foot, calf lateral skin sensory numbness, should be timely and closely to be comprehensive treatment. Observation and care of drainage tube after hip joint surgery, negative pressure drainage tube can be placed, the incision site seepage, blood drainage, to prevent blood and infection in the joint, so the patient back to the ward, the nurse should confirm the location of the drainage tube, properly fixed, to prevent falling off, folding, blocking, regularly squeeze the drainage tube to ensure that the smoothness of the drainage tube, and at the same time, postoperative observation of the amount of drainage fluid and the nature of the drainage, if the drainage flow is small, the hip joint fullness or swelling, the appropriate care should be taken in a timely manner, and should be treated promptly. At the same time, the amount and nature of drainage fluid should be closely observed after operation, if the drainage flow is small, the hip joint is full or swollen, corresponding nursing measures should be taken in time, such as adjusting the position of the affected limb and replacing the negative pressure drain. Functional exercise (I) Early stage: 2-7 days after surgery, keep the affected limb in the neutral position with 15-30 degrees of abduction, wear “T” shoes to prevent hip dislocation. 1, muscle isometric contraction exercises, the so-called isometric contraction is the active contraction of the muscle but does not cause joint movement. The isometric contraction of quadriceps muscle should be practiced on the second day after surgery. Methods: The nurse stands on the affected side of the patient, places the right hand on the N fossa of the affected limb, and the left hand on the knee joint, palms facing each other. Ask the patient to straighten the knee, the affected limb downward pressure on the nurse’s right hand after relaxation, the nurse’s left hand is clearly felt patella up and down once. So repeated downward pressure relaxation action, the quadriceps can get better isometric contraction. Generally, after instructing the patient for 2~3 times, the patient can well grasp the main points of the movement, and then carry out active practice. Repeat 20 times/group, gradually increasing to 40 times/group, 2~3 groups per day. 2, toe flexion and dorsiflexion exercises: mainly to maximize the flexion and extension of the affected limb small joints, and drive the calf muscle movement. Avoid internal and external rotation of the hip joint. Keep each movement for 10 seconds, repeat 20 times/group, 2~3 groups per day. 3, hip contraction exercise: patients lying down, contraction of the gluteal muscles to hold 10 seconds, relax; hands on the ground, do hip lifting action, hold 10 seconds, repeat 20 times / group, 2 ~ 3 groups per day. 4.Straight leg raising exercise (active, passive): raise ≤ 30 °, hold time 10 seconds to gradually increase to 20 seconds. Deep breathing exercises should be performed at the same time. The frequency and intensity of the exercises are generally 5-10 minutes for every interval of 1~2 hours, to the extent that you do not feel very tired. On the third day after surgery, you can sit up under the doctor’s guidance and perform mild hip flexion exercises, which should not be too long, generally limited to half an hour. Starting functional exercise as early as possible is a fundamental measure to prevent deep vein thrombosis. (ii) Mid-term: 8-15 days after surgery, continue early functional exercise. 1, supine hip flexion and knee flexion exercise: one hand rests on the knee, one hand rests on the heel, flex the hip ≤ 90° without causing abnormal pain, and prohibit internal rotation of the hip joint, otherwise it will lead to hip dislocation. 2.Recumbent to sitting position exercise: use both hands to support the bed, flex the healthy leg to extend the affected leg, use both hands and the healthy leg to support the affected leg to naturally hang down under the bed, 2~3 times a day. 3, sitting to standing position point training: patients first sit up in bed, no dizziness and other symptoms, sit down on the edge of the bed, first under the healthy limbs and then under the affected limbs, hands to hold the edge of the bed, and gradually get out of bed. No dizziness, palpitations and other symptoms and then start to stand by the bedside with the help of crutches for 10 seconds/group, 2~3 times a day. 4, help the crutches bedside standing practice walking: walking should help the crutches not weight walking, someone in the side protection. 20 seconds each time, 2~3 times a day. After 6–8 weeks after the operation, you can partially bear weight. The healthy leg steps first, the affected leg follows, and the crutches follow. The step of holding the crutches is the focus of education: the correct posture of crutches: the height of the crutches should be adapted according to the patient’s height, the general height of the patient’s hands to hold the crutches, the top of the crutches from the armpits of the armpits of the 5 ~ 250px, the same width as the shoulders. Because the force of holding the crutches in both hands rather than rely on the armpits to support the body, otherwise it is easy to cause brachial plexus nerve paralysis, once it occurs, although it can be recovered after resting, but it will affect the patient’s mood and the process of functional exercise. Correct walking method: stand up well, first out of the left crutch, step right foot, out of the right crutch, step left foot. Correct posture for going up and down the stairs: when going up the stairs, the healthy limb goes up first. When going down the stairs, the affected limb goes down first. (iii) Post-operative period: 3 weeks – 3 months after the operation, patients in this period are usually discharged from the hospital and go home, continue to carry out functional exercise in the middle period, and gradually increase the time and frequency of exercise. Within 6 weeks after surgery, “six don’ts”: 1, don’t cross your legs; 2, don’t lie on the affected side (if you lie on the affected side, you should put a soft pillow between your legs); 3, don’t stilt your legs; 4, don’t lean forward when sitting; 5, don’t bend over to pick up things; 6, don’t sit with your knees bent in bed. Abandonment of crutches time varies from person to person, usually after walking steadily and without walking pain. After full recovery, you can carry out appropriate physical activities, such as walking, dancing, cycling, etc. You should avoid heavy labor and strenuous exercise. Squatting position should not be used for defecation. The purpose of follow-up visits at 1 month, 2 months, 3 months, 6 months and 12 months after surgery, and then annually thereafter, is to guide the patient to further rehabilitation training and protect the use of artificial joints, in order to achieve the best results of the surgery.