To explore the effects of different surgical timing on the operative efficacy and postoperative complications of elderly hip fractures, and to provide evidence for the establishment of the green channel for the treatment of hip fractures in China.

A retrospective analysis was conducted on hip fracture patients admitted to the Third Affiliated Hospital of Guangzhou Medical University and Liwan Central Hospital of Guangzhou from January 2019 to June 2022. Inclusion criteria: first-time hip fracture, injury time <24 h, receiving surgical treatment. Exclusion criteria: age <80 years, open fractures, pathological fractures, and multiple fractures. A total of 150 patients were included in the study, divided into the early surgery group (75 cases) and the delayed surgery group (75 cases). The early surgery group underwent surgery within five days of admission, while the delayed surgery group underwent surgery after five days of admission. Comparisons between the two groups were made using t test and chi square tests for surgical timing, intraoperative blood loss, and postoperative complication rates during hospitalization.

There was no statistically significant difference in operation time ［(94±15) min vs(93±18) min］ or intraoperative blood loss ［100(80, 200) ml vs 100(95, 200) ml］ between the two groups (both P>0.05). The length of hospital stay(18±7) d in the early group was lower than that in the delayed group(21±5) d, and the difference was statistically significant (t=0.001, P<0.05). In the early group, incision infection rate was 4.0% (3/75), urinary tract infection 1.3% (1/75), cerebrovascular accident 1.3% (1/75), myocardial infarction zero(0/75), and lower limb venous thrombosis 1.3% (1/75). Compared with the delay group, of which these incidences were 5.3% (4/75), 2.6% (2/75), 2.6% (2/75), 1.3% (1/75), 1.3% (1/75) respectively, the differences were not statistically significant (all P>0.05). The incidences of postoperative pulmonary infection and bedsore were 1.3% (1/75) and 1.3% (1/75) respectively in the early group, which were lower than those in the delayed group ［13.3% (10/75) and 10.6% (8/75)］; the differences were statistically significant (χ²=0.012, 0.039, both P<0.05).

In elderly patients with hip fracture, surgery within 5 days can reduce the incidence of postoperative pulmonary infection and bedsore.