Patient: Hello doctor, my grandfather, 85 years old, formerly diabetic, hypertensive, well controlled by medication, had a comminuted fracture of the femoral trochanter in his right leg on April 30, conservative traction, wheezing badly on May 23, was sent to Nanjing Pukou District Central Hospital, now to the respiratory department for treatment, breathing smoothly. Blood pressure is normal In the respiratory department, oxygen, hanging water, insulin, leg steel traction, now the person is thin, stable state, slightly high blood sugar. History type: CT film Examination time: 2012-05-31 Image description: scattered patchy high-density shadow in the left lung with blurred edges, slightly narrowed bronchus in the right lower lung, moderate amount of fluid accumulation shadow in both thoracic cavities, partial parcel formation in the left thoracic cavity, slightly collapsed left chest wall, mediastinal cardiac shadow slightly shifted to the left, no obvious enlarged lymph node shadow in the mediastinum, enlarged cardiac shadow, patchy aortic wall and coronary artery wall The rest of the patients did not show any significant abnormalities. Diagnosis: inflammation of the left lung, right lower lung occupancy to be excluded. The diagnosis was: pleural effusion on both sides, encapsulated effusion on the left side, and partial underinflation of both lower lungs. Chest, plain examination Hospital: Pukou District Central Hospital Diagnosis: left lung inflammation, right lower lung occupancy to be excluded; pleural effusion on both sides, encapsulated effusion on the left side, partial under-expansion of both lower lungs. The test list shows: low protein, low potassium, low Na The film was taken yesterday, you help me see how his legs are growing now, about how long it takes to sit up? Is it healed? Should I continue traction or surgery as the next step in treatment? Thank you! Ni Rong Bao, Department of Orthopedics, General Hospital of Nanjing Military Region: Hi, the mortality rate of intertrochanteric fractures in elderly people over 80 years old was very high in the past, because pneumonia caused by long-term bed rest in elderly people is fatal, and we now advocate early joint replacement surgery for patients in this age group, after which they can go down to the ground within 1-3 weeks to prevent pneumonia. Of course conservative treatment is not good, but the opportunity for surgery is now lost and the pulmonary complications are already severe. The films show some healing of the fracture site, but not complete, and the fracture line is still visible. 3 months of traction is usually needed, or 1.5 months of traction plus a month and a half of thimble braking (which would be more comfortable). But it is hard to say whether the elderly will survive the next 1.5 months. First of all, nutritional problems, low protein, low potassium, low nano, indicating a very bad diet, to find ways, if necessary, to do parenteral nutrition, you can find our general surgery department director Wang novelty consultation online, she specializes in parenteral nutrition. Second, actively treat pulmonary complications and prevent decubitus ulcers, which is mainly a matter for the hospital.