Osteoporotic fractures are characterized as fragility fractures, which occur in the spine, hip, proximal humerus, and distal radius and ulna in the elderly. The problems include loosening of internal fixation, re-fracture, and high disability and mortality rates. The treatment is simultaneous treatment of fracture and osteoporosis. Clinical manifestations of osteoporotic fracture 1. general manifestations: pressure pain, pain or aggravation of existing pain; 2. specific manifestations: deformity, bone rubbing sensation, abnormal activity, functional impairment; 3. spinal deformation: short height or hunchback deformity; diagnosis and differential diagnosis 1. gender: common in women, also seen in men; 2. age: mostly seen in elderly people over 60 years old; 3. history of trauma: only minor trauma or Clinical manifestations: pain, deformity, dysfunction; 5. imaging: generally, frontal and lateral X-rays are required to reasonably apply CT, MRI, CT three-dimensional imaging techniques; 6. bone density examination: dual-energy X-ray absorptiometry (DXA); 7. laboratory tests: blood and urine routine, liver and kidney function, blood glucose, calcium, phosphorus, alkaline phosphatase, 25(OH)D and thyroid hormone; 8. 8. differential diagnosis: bone tumor, secondary osteoporosis and fracture due to bone disease; 9. risk factors: (1) primary risk factors: low bone mineral density, history of fragility fracture, advanced age > 65 years, family history of fracture (2) Secondary risk factors: falls, smoking, alcohol abuse; hypogonadism, early menopause (<45 years); history of drug use; hyperthyroidism, parathyroid resistance; long-term malnutrition and other diseases.