{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:14:59Z","timestamp":1786122899283,"version":"build-2736575974"},"reference-count":219,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Hip fractures are among the most devastating fragility fractures, associated with excess mortality, disability, loss of independence, and substantial healthcare costs. Although age-standardized incidence has declined in several high-income countries, absolute case numbers continue to rise because of population aging. This review summarizes contemporary PubMed-indexed evidence on the epidemiology, risk stratification, and prevention of proximal femoral fractures, with emphasis on hip-fracture outcomes rather than vertebral or composite endpoints alone. We discuss secular trends, FRAX-based case findings and screening, non-pharmacologic strategies, pharmacologic therapy, and health-system interventions relevant to both primary and secondary prevention. Among non-pharmacologic measures, long-term balance-challenging and resistance-based exercise has the most consistent evidence for reducing falls and likely contributes to fracture prevention, whereas multifactorial interventions, home hazard modification, calcium\/vitamin D supplementation, and hip protectors are best targeted to selected high-risk populations and care settings. Among medications, bisphosphonates, denosumab, and romosozumab-based sequential strategies show the strongest evidence for reducing hip-fracture risk, while teriparatide and abaloparatide have important roles in very-high-risk patients despite less direct hip-fracture evidence. Menopausal hormone therapy reduces hip fractures in younger postmenopausal women but is limited by extra-skeletal risk, and selective estrogen receptor modulators are primarily vertebral-fracture agents. A major message of this review is that effective prevention depends not only on drug efficacy but also on implementation. Fracture liaison services, orthogeriatric co-management, prompt treatment after fragility fracture, and sustained adherence support are essential to close persistent care gaps. Preventing hip fractures therefore requires an integrated, risk-stratified approach that combines skeletal protection, falls prevention, and reliable health-system delivery.<\/jats:p>","DOI":"10.3390\/jcm15166148","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T13:20:16Z","timestamp":1786108816000},"page":"6148","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preventing Hip (Proximal Femoral) Fractures: An Evidence-Based Review for Clinicians"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3988-6411","authenticated-orcid":false,"given":"Toshiyuki","family":"Kawai","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaichiro","family":"Okuzu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0886-7763","authenticated-orcid":false,"given":"Yusuke","family":"Takaoka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daichi","family":"Natsume","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Dyer, S.M., Crotty, M., Fairhall, N., Magaziner, J., Beaupre, L.A., Cameron, I.D., Sherrington, C., and Fragility Fracture Network (FFN) Rehabilitation Research Special Interest Group (2016). 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