Hip fractures are recognized as a major public health problem worldwide. De
mographic changes will lead to enormous increases in the number of hip frac
tures and projections indicate that the number of hip fractures occurring w
orldwide each year will rise from 1.26 million in 1990 to 4.5 million by 20
50. However, preventive strategies are available. Supplementation with Ca2 and vitamin D restores bone quality through suppression of secondary hyper
parathyroidism and decreases the risk of falling through improvement of neu
romuscular coordination and body sway. This leads to a reduction of hip fra
cture risk of 43% in the vitamin D-insufficient elderly. Treatment with the
bisphosphonate alendronate increases bone strength and results in a 51% re
duction of hip fracture risk. Hip protectors absorb energy during a fall an
d reduce hip fracture risk by 56%. Combining these three procedures could p
revent a large proportion of hip fractures in the future.