[Four major fractures in elderly].

Fractures of proximal humerus, distal radius, proximal femur and vertebral body are common in elderly patients with osteoporosis. These so called "four major fractures in elderly" can be difficult to treat because of fragile bone. They can be treated either conservatively or surgically. Except for proximal femur fracture, conservative treatment is performed as first line therapy. To avoid complications associated with conservative treatment, surgical treatment has been developed and proves to be effective. However, the risk of surgical stress and the possibility of postoperative complication have to be estimated carefully before surgery. While fracture is treated, osteoporosis should also be treated in order to prevent another fracture.