1, what is the hip fracture in the elderly? When it comes to fractures, the first thing many people associate with traffic accidents, earthquake collapses, and falls from height …… The main causes of fractures in young people are indeed these. However, for the elderly, a gentle bend or even a sneeze can lead to a fracture. The old saying “the bones of the elderly are more brittle” actually has some truth to it, because the incidence of osteoporosis in the elderly is higher, and the bones are more brittle, not a great external force can cause fractures. And once the elderly fall, hip fractures often occur. Hip fracture used to be called “the last fracture of life”, which means that people are prone to fracture when they are old, and once a fracture occurs, their lives are in danger. The fracture itself is not terrible, but the various complications can be fatal. What’s so special about hip fracture? First of all, we need to clarify where the “hip” is. In layman’s terms, it is the part where the thigh meets the hip, which is often referred to as the crotch. The hip joint is an important structure that connects the trunk and the lower limbs. Therefore, once the hip fracture, patients are mostly unable to walk, and long-term bed rest is a serious blow to patients psychologically and physically. 2.What to do after hip fracture in the elderly? If the indications for surgery are met, surgery is the preferred treatment for hip fracture in the elderly. Why is surgery the preferred treatment? At such an old age, can you still afford surgery? In fact, the evaluation of whether a person can withstand surgical trauma is not based on age, but on the status of all systems. The physical condition of the same 80-year-old person is different. Some people have various examinations and find that many organs have hidden problems, while others have no problems after blood sampling. Therefore, age is not the only decisive factor, and it is not uncommon for centenarians to undergo hip surgery. Reasons for preferring surgical treatment: conservative treatment does more harm than good; modern surgical treatment has manageable risks and many benefits. (1) Conservative treatment By conservative treatment, we generally mean bed rest, traction and fixation, and waiting for the fracture to heal on its own. The cost seems to be low, no surgery and bleeding, and it feels as if it is safe, but in fact there are more disadvantages: care is difficult: the elderly are bedridden for a long time, need to do traction through steel pins in the legs, absolutely cannot get out of bed, and have to urinate and defecate in bed. Every time you move your body or turn and pat your back, it causes severe pain at the fracture site. It is a kind of torture for both the patient and the family. Long time in bed: Generally, hip fracture usually requires bedside traction and braking for 2 to 3 months or even longer, which is often unbearable for patients. Complications: prolonged bed rest and compression of the hip and lower back can cause poor local blood supply and bed sores; prolonged braking can lead to muscle atrophy; the incidence of pneumonia and urinary tract infections can also be greatly increased, which can be life-threatening in serious cases. The treatment effect is poor: except for a few mild fractures with special location and active cooperation of patients, most patients’ fractures tend to heal abnormally or even not, which affects the quality of life in the future. Several studies have even found that the mortality rate of elderly patients with periprosthetic hip fractures after conservative treatment is close to 50%. (2) Surgical treatment Modern surgical techniques are very mature, and most patients can get out of bed within a week after surgery, thus avoiding the serious complications that may occur after prolonged bed rest. More importantly, surgery can restore the function of the hip joint, and recovery is fast. They can return to their original life trajectory soon. In recent years, orthopedic surgery has progressed by leaps and bounds, and diseases that were thought to be treated conservatively in the past now have excellent surgical options. The mortality rate for surgical patients is also much lower than conservative treatment, and the recovery of joint function is much better. There are risks associated with any surgery, but thorough preoperative preparation can minimize it. The condition of vital organs is examined in detail before surgery, chronic diseases are controlled before surgery, anemia is treated with blood transfusion, and inflammation is treated with anti-infection treatment. Even so, doctors will still assess the risk of surgery before surgery and will only recommend surgery if the risk is manageable. Of course, controlled risk is not the same as no risk. It is just that the overall benefit of surgery is greater compared to conservative treatment. Conservative treatment is only suitable for patients with multiple serious preoperative comorbidities, who are extremely weak and cannot tolerate surgery. (3) Another very important point is that prevention is the best treatment! For elderly people there is usually no fall and no fracture, so how to prevent falls? Modern nursing believes that it is related to the humidity and brightness of the environment and surrounding obstacles, while certain medications such as glucose-lowering, pressure medications, sedatives, and dehydrating agents can affect falls in the elderly. Prevention of these risk factors for falls can reduce the risk of falls and fractures in the elderly. In addition, the prevalence of osteoporosis in the elderly has been increasing in recent years, and osteoporosis is the most dangerous killer that causes fractures in the elderly, and active prevention and treatment of osteoporosis can effectively reduce the risk of fractures.