Elderly people are prone to falls resulting in frequent fractures due to poor limb flexibility. At the same time, with the increasing aging of society, the incidence of hip fractures in the elderly is on the rise in general. Complications of hip fracture in the elderly mainly include bed sores, lung infections, urinary tract infections, and even venous embolism and pulmonary embolism in the lower extremities due to prolonged bed rest, which may threaten the life of elderly patients. So, how to prevent and treat hip fracture in the elderly? First, the “culprit” of hip fracture in the elderly is osteoporosis Hip fracture usually refers to the fracture of the femoral trochanter and femoral neck fracture. Osteoporosis is the intrinsic basis of hip fracture in the elderly, and falls are the most common external factor for the elderly. The human body ages and osteoporosis occurs gradually. And of all fractures due to osteoporosis, hip fractures occur at the highest rate. Osteoporosis is a bone lesion caused by various reasons, which is characterized by a proportional decrease in bone mass, bone mineral composition and bone matrix, thinning of bone cortex, reduction in the number and size of bone trabeculae, and decrease in bone strength thus making the body prone to fracture. At present, about 25% of the elderly in China are patients with osteoporosis. They can have more serious fractures under some low energy impact. Risk factors for osteoporosis include age, gender, race and genetic factors, endocrine factors, nutritional factors and behavioral factors. Among them, the risk of osteoporosis increases with increasing age. Falls are the most common form of trauma in the elderly. more than 90% of hip fractures in the elderly are caused by falls. This is associated with limited joint motion due to age-related osteoarthritis, decreased muscle strength, and altered muscle tone due to crestal degeneration. Hip fractures are caused when abnormal body stability occurs, protective positioning cannot be accomplished in an instant, and stress is excessively concentrated in the hip. For older adults over the age of 65, 87% of fracture occurrences can be attributed to falls. Between 1% and 5% of falls are caused by clear intrinsic body factors, such as syncope and stroke. Also, the diminished visual, auditory, tactile, and vestibular sensory functions of the elderly are important factors in causing falls. When trauma occurs, the patient may have shortening of the affected limb, external rotation and abduction deformity, swelling and pain of the hip or pressure pain, sometimes localized bone rubbing sensation can be felt, hip joint movement is limited, and the hip fracture can be seen on X-ray. Second, how to prevent hip fracture in the elderly The elderly can mainly pay attention to two aspects: diet and action. First of all, dietary calcium is the main source of calcium for the body, and calcium is an important element for the growth and metabolism of the skeletal system. Maintaining the adequate amount of calcium required by the body can play a protective role against osteoporosis in the elderly. In your daily diet, you can eat more calcium-rich foods such as dairy products, soy products, shrimp, eggs, fish, green leafy vegetables, cauliflower and seaweed. In addition, smoking, drinking alcohol and coffee may cause accelerated loss of bone mass and should be avoided as much as possible. Second, physical exercise is an important means of preventing osteoporosis and fractures. Lack of exercise makes the mechanical stimulation of bones and osteoblasts weaken, resulting in muscle atrophy, increased bone resorption and reduced bone formation. Therefore, moderate exercise should be maintained, and more sun exposure should be provided to synthesize more vitamin D to assist in calcium absorption. Thirdly, elderly people should avoid environmental risk factors that cause falls, including smooth floors, uneven floors, dim lights, loose or wrinkled carpets, unstable furniture and objects on the floor; they should also avoid dangerous movements such as climbing ladders, lifting heavy objects or participating in athletic activities. Elderly people with obvious symptoms of osteoporosis should avoid going out alone unaccompanied. Treatment of femoral neck fracture For elderly patients who have already fractured, treatment should be based on the patient’s preoperative physical condition, fracture type and other factors to choose the appropriate treatment method for the patient. The treatment of femoral neck fracture can be divided into two categories: non-surgical treatment and surgical treatment. The main methods include plaster fixation, bed traction and “Ding” anti-rotation shoe fixation, etc. The purpose is to rebuild the function of the hip joint as soon as possible. However, the disadvantage of this method is that bone discontinuity and shortening of the lower limb of femoral head necrosis may still occur after treatment. Therefore, for elderly femoral neck fractures, except for those with serious underlying diseases or those who cannot tolerate surgery, surgical treatment is generally advocated. With the maturation of surgical techniques and the development of endoprosthesis, the surgical treatment of femoral neck fractures in the elderly has been increasingly recognized. The common surgical procedures for elderly femoral neck fractures include closed or incisional internal fixation and hip arthroplasty. For relatively young femoral neck fractures, or for elderly femoral neck fractures that cannot tolerate joint replacement surgery, closed or incisional internal fixation is the preferred treatment method, which is not only simple to perform, but also less traumatic and less bleeding. At present, the more commonly used internal fixation methods are hollow screw internal fixation, sliding screw plus lateral plate internal fixation, etc. Regardless of the chosen method, good repositioning is required. Despite the advantages of internal fixation, there are still defects such as postoperative osteoconnection, femoral head necrosis and even the need for secondary hip replacement surgery. In recent years, prosthesis replacement has become the preferred treatment for femoral neck fracture in China, which can solve the complications caused by femoral neck fracture such as bone non-union and femoral head necrosis, enable patients to get out of bed early, reduce the complications caused by long-term bed rest, restore normal living ability as soon as possible, and improve the quality of life. There are two main types of prosthetic replacements in common use, namely hemi hip replacement and total hip replacement. Half-hip replacement can be divided into two types: unipolar artificial femoral head and bipolar artificial femoral head replacement. For older patients or relatively young elderly patients with poor physical condition, bipolar biological artificial femoral head replacement is recommended; for older patients with obvious osteoporosis, bipolar cemented artificial femoral head replacement is recommended. Femoral head replacement can avoid complications such as femoral head necrosis, bone discontinuity, and internal fixation failure, but the acetabulum is subject to greater wear and tear than the total hip joint due to the enlarged femoral head replacement prosthesis. As the acetabulum wears, the replaced femoral head will dislocate toward the center of the acetabulum, which has obvious limitations in use and the long-term effect is not as good as total hip replacement. Because of the simple operation, short operation time and relatively small trauma compared to total hip replacement, simple artificial femoral head replacement can be considered for patients over 80 years old, occasional outdoor activities or super advanced age. Total hip replacement is mainly divided into two types: cemented and biological. Compared with artificial femoral head replacement, total hip replacement is suitable for patients with better physical condition, healthier, higher requirements for functional recovery, high activity and higher requirements for quality of life. 10-year excellent rate of total hip joint has exceeded 90%. For relatively young, older patients with better physical conditions, it is recommended to choose biologic type total hip arthroplasty; for relatively young, older patients with osteoporosis, cemented type total hip arthroplasty can be chosen. For the elderly, hip fracture is an important life-threatening disorder. As China enters an elderly society, attention should be paid to it, both from the perspective of rational application of medical resources and reducing the burden on society. Therefore, reasonable changes in home life and social environment should be made to reduce the chances of falls and the onset of osteoporotic diseases in the elderly. After the occurrence of hip fracture, the overall condition of the patient should be evaluated, the fracture should be reasonably managed, and complications should be detected and treated early to reduce the morbidity and mortality rate and improve the prognosis.