Osteoporosis is a genuine concern nowadays, especially with the increasing life span of most populations; consequently, there is a rise in fragility fracture incidence. These fractures burden the healthcare system, so proper management and prevention of failure and subsequent revision surgeries are paramount. Various fracture fixation implants were suggested for managing fragility fractures, especially locking plates. Although many advancements have been introduced to these implants, failure still occurs. Some of the modifications applied on locked plates to improve their efficiency included hydroxyapatite-coated (HAp) screws, polyaxial locking plates, and Bone–Screw-Fastener. Furthermore, various augmentation techniques were used, which improved fracture fixation strength and reduced failure rates, such as polymethyl methacrylate, calcium sulfate, and calcium phosphate. The possibility of bone defect and the need for its reconstruction is another crucial point that must be considered while dealing with a fragility fracture to reduce the incidence of delayed or nonunion. Bone defect reconstruction strategies include HAp, bioceramics, β-tricalcium phosphate, and mesoporous bioactive glass scaffolds. Local drug delivery is an appealing option for managing fragility fractures, and it includes antiresorptive and anabolic agents that could be delivered through nanoparticle-based drug delivery or hydrogels. The future carries more promising advancements and improvements in the strategies to manage fragility fractures, including improving local drug delivery techniques and using innovative implants that could monitor stages of fracture union.