The old man fell down and broke his bone. Operation? No surgery?

Speaking of fractures, The first thing many people think of is traffic accidents, earthquakes, landslides, falls from heights… These are indeed the main causes of fractures in young people. But for the elderly, A slight bend or even a sneeze can cause a fracture. As the saying goes [old people’s bones are brittle], there is a certain truth in it. Because the incidence of osteoporosis in the elderly is relatively high, Bone fragility is relatively large, Not too much external force can cause fractures. However, once the elderly fall, The common occurrence is hip fracture. Hip fracture used to be called [the last fracture in life], which means that when one gets old, one is prone to fracture, and once one breaks, one’s life is in danger. Fracture itself is not terrible, but various complications can be fatal. Hip fracture is special in what? First of all, we need to know where the [hip] is. Generally speaking, it is the part where the thigh and hip are connected. This is what people often call the hip (ku à). The hip joint is an important structure connecting the trunk and lower limbs. On one side is the pelvis, On one side is the femur, The part that connects the two is the hip joint. Consisting of the femoral head and acetabulum, It carries the weight of the upper part of the human body, It directly affects standing and walking. So, Once the hip is broken, Most patients cannot walk, Long-term bed rest is a serious psychological and physical blow to patients. Fracture in the elderly, Most people think of [no surgery], or [no surgery if you can]. The reason sounds very simple, [so old, afraid of not being able to bear the blow of surgery]. However, it should be pointed out that under the premise of meeting the surgical indications, the elderly hip fracture should be treated surgically. Why is surgery preferred? In fact, to evaluate whether a person can bear surgical trauma, one does not look at his age, but at the state of all systems in the body. Both are 80-year-old people, but their physical conditions are different. Some people have done various examinations and found that many organ functions have hidden dangers. There is no problem after some people draw blood for filming. Therefore, age is not the only decisive factor, and hip surgery is not uncommon for centenarians. There are two reasons for the preferred surgical treatment: conservative treatment does more harm than good; The risk of modern surgical treatment is controllable, There are many benefits. 1. Conservative treatment. The so-called conservative treatment, Generally speaking, it is bed rest, traction fixation, Waiting for the fracture to heal itself. The cost is low, No surgery, bleeding, It feels like it’s safe, But in fact there are more shortcomings: Nursing is difficult: The elderly stay in bed for a long time, You need to pull through a steel needle on your leg. Never get out of bed, You should also defecate and urinate in bed. Every move or turn over and pat your back will cause severe pain at the fracture site. It is a kind of torture for patients and their families. Long bed stay: Generally, hip fractures usually require bedside traction and braking for 2-3 months or even longer, and patients are often miserable. There are many complications: long-term bed rest compresses buttocks, waist and back will cause local poor blood supply and bedsore; Long-term braking will lead to muscle atrophy; The incidence of pneumonia and urinary tract infection will also increase greatly. Serious cases are life-threatening. The treatment effect is not good: Except for a few fractures with special location, In addition to the mild fractures that the patients actively cooperated with, Fractures in most patients are prone to malunion, Affect the quality of life in the future. More studies have found that, The mortality rate of elderly patients with perihip fractures after conservative treatment is close to 50%. 2. Surgical treatment Modern surgical techniques are mature. Most patients can get out of bed and move within one week after operation, thus avoiding serious complications that may occur when they stay in bed for a long time. More importantly, surgical treatment can restore the function of hip joint and recover quickly. Soon you can return to the original life track. Is there no problem with surgery? Such doubts are understandable. In the past, The operation of hip fracture is traumatic, Surgical techniques are relatively backward, There is little difference in the effect of surgery or not. In recent years, Orthopaedic surgery is progressing rapidly, Diseases that were supposed to be treated conservatively in the past, Now there are good surgical plans. The mortality rate of patients undergoing surgery is also far lower than that of conservative treatment. The recovery of joint function is also better. Any operation is risky, However, thorough preoperative preparation can minimize it. The condition of important organs of the body will be examined in detail before surgery. If there is a chronic disease, it will be too late to control the disease before surgery. Preoperative anemia can be blood transfusion, inflammation can also be anti-infection treatment first. Even so, doctors will still assess the risk of surgery before surgery, only the risk is controllable, will suggest active surgical treatment. Of course, controllable risks do not mean no risk. Only compared with conservative treatment, the overall surgical benefits are greater. How to do the operation? Can I not change my joints? Fracture treatment, The most common ones are [steel plate] [steel nail] or [joint replacement]. That is, internal fixation and artificial hip replacement in medicine. 1. Hip replacement is indeed, [Own] will be better. But the broken ones cannot be kept. For anatomical reasons, Most of the femoral neck fractures in hip fractures have low healing ability, The probability of femoral head necrosis is high. Some patients can’t grow up after conservative treatment for several years. Even if some old people heal their fractures, After a few years, femoral head necrosis occurred again. When I entered the hospital again, I was very passive. Therefore, Doctors tend to replace artificial joints for femoral neck fractures with obvious displacement. Joint replacement is like installing dentures. Although the trauma is not the same, the essence is the same. Remove the broken ones and replace them with fake ones. Can accept dentures and why can’t artificial joints be accepted? 2. There are several kinds of fractures around hip joint due to internal fixation, The body functions of the elderly are also different, Intertrochanteric fractures in hip fractures generally have better blood supply, Fracture healing is not a problem, doctors generally use the method of closed reduction and internal fixation. No incision is required when reducing, only a few small incisions are made when placing internal fixation, and the operation can be completed in a very short time. In addition, internal fixation treatment can also be considered for femoral neck fracture with no obvious displacement. Is it [steel nail] or [joint replacement]? It is also necessary for the competent doctor to make a comprehensive judgment according to the patient’s condition and general condition. At this time, communicate more with doctors and refer to the opinions of professionals to face difficulties together. Who is suitable for conservative treatment? It is human nature to seek benefits and avoid disadvantages. But sometimes the reality is very cruel. If the patient’s preoperative evaluation is found to be intolerant of surgical treatment, The conservative treatment in bed has become [Huashan Road]. Therefore, conservative treatment is only suitable for patients with various serious combined diseases before operation, extremely weak and unable to tolerate surgery. Finally, there is another very important point: prevention is the best treatment. No fall, no fracture! Click View > > How to Prevent Falls