With increasing longevity, hip fractures become more and more a serious burden
not only for societies in developed civilization, but also for emerging
countries. According to world-wide projections 1.5 million people are affected
each year. Although a lot of research has been performed over the last decade,
there is still a lack of standardized and evidence-based approaches for
prevention, treatment, and rehabilitation of this worst complication of
osteoporosis.Therefore, the evidence base for this article was synthesized in accordance with
SIGN methodology. Databases searched include Medline, Embase, Cinahl and the
Cochrane Library between March 1999 and March 2019. The following terms are
used: osteoporosis, hip fracture, rehabilitation, falls, muscle strength,
nutrition, exercise, balance, sway, and hip protectors. Moreover, reference
lists from included studies were checked and author`s names were searched for
additional studies.Possibly, the best approach to rehabilitation after hip fracture is a
multi-disciplinary team co-ordinating medical, social, educational and
vocational measure for training or retraining the individual to the highest
possible level of function. In order to prevent thromboembolism low-dose
anti-coagulation therapy (e. g. fondaparinux, rivaroxaban) may be used for
approximately two weeks after surgery. This should be accompanied by a daily
nutritional intake of at least 20 g protein, 1200 mg of elemental calcium and
800 I. U. of vitamin D, whereas in severe vitamin D insufficiencies
recommendations may be certainly higher.After surgical repair of the hip fracture, an anti-resorptive medication may be
started. While balance training and performing of Tai Chi has been shown to
reduce fall risk and thereby also decrease hip fracture risk, the use of hip
protectors is still under evaluation and cannot be generally advocated.