100 years old, with poor cardiopulmonary function, having just undergone left femoral head replacement a year ago, and now the right femoral neck is fractured again.

Such a extreme old age + high-risk" combination is almost pushed to the edge of the surgical contraindication zone. But if surgery is not performed, the elderly patient is likely to be bedridden and never get up again. Recently, the team led by Director Liu Huiliang of the Orthopedics and Traumatology Department of Guangdong Clifford Hospital successfully resolved the problem for 100-year-old Grandpa Jiang (pseudonym).

02
Centenarian Falls Again: Surgery or "Toughing It Out"?

Although Mr. Jiang is advanced in age, he was still able to walk slowly and take care of himself. However, a sudden dizziness caused him to fall heavily, with severe pain in the right hip and inability to move. His family called for emergency services and sent him to Guangdong Clifford Hospital. The subsequent examination results were as expected: a subcapital fracture of the right femoral neck.
What made the situation tricky was that this was not his first time encountering such a fracture—one year earlier, he had just undergone artificial femoral head replacement at the same location on the left side. Even more concerning, his cardiopulmonary functional reserve was extremely low, and his tolerance for anesthesia and surgery was poor.
Before the family lay the classic dilemma:
Conservative treatment: Long-term bed rest makes pulmonary infection, deep vein thrombosis, and pressure injuries (bedsores) almost inevitable. Clinical data show that the mortality rate within one month of conservative treatment for femoral neck fractures in the elderly is quite high.
Surgical treatment: Anesthesia risk, intraoperative circulatory fluctuations, postoperative infection... every step is like walking on thin ice.
Director Liu Huiliang organized a multidisciplinary consultation involving the Cardiology Department, Respiratory Department, Anesthesiology Department, and others to discuss the treatment plan, prepare risk contingency plans, and communicate repeatedly with the family. The team ultimately decided—to operate, and to do so quickly, steadily, and precisely.
 

02
This Time, They Chose "Not to Lie Down"

Orthopedics and Traumatology team during surgery

The surgical team consisted of Associate Chief Physician Li Yannan, Attending Physician Liang Zhennan, Attending Physician Zhao Xiong, Attending Physician Cao Zihao, and others. With skilled technique, the team precisely performed osteotomy, expanded the medullary cavity, conducted trial fitting, and successfully implanted a biological artificial femoral stem + artificial femoral head. The entire surgery took about 1 hour, the elderly patient's vital signs remained stable, and he returned safely to the ward.

After surgery, Dr. Liang Zhennan guided walking

On the second day after surgery, the medical and nursing team guided Grandpa Jiang to sit up, and after he could sit steadily, gradually transitioned to standing at the bedside and walking with a walker. Before discharge, Grandpa Jiang was already able to walk steadily in the corridor with the help of a walker.
The Orthopedics and Traumatology team explained that this was a scientific decision based on the Enhanced Recovery After Surgery (ERAS) concept—early activity and early mobilization are the only way to effectively prevent pneumonia, thrombosis, and muscle atrophy. Especially for elderly patients, one day in bed means one degree of functional decline.

03
A Reminder for Children with Elderly Parents at Home

The Orthopedics and Traumatology team reminds that femoral neck fracture in the elderly is often called the "last fracture in life"—not meaning that after this recovery there will be no more fractures, but that many elderly people, once it occurs, are never able to get out of bed again.
However, "advanced age" itself should not be a reason to give up surgery. What truly determines the plan is the patient's overall condition, cardiopulmonary compensatory capacity, nutritional status, and willingness to rehabilitate. With full assessment and multidisciplinary support, age is just a number, not an absolute contraindication zone.
Two key points:
Seek medical attention immediately after a fall; do not "wait and see"—the earlier the surgery, the fewer the complications and the easier the recovery.
Trust professional assessment rather than being deterred by "old age"—today's anesthesia and minimally invasive techniques have made great progress, and many super-elderly patients can also safely make it through the surgical period.