ObjectiveTo analyze the changing trends in disease burden of femoral fractures in China from 1990 to 2021, evaluate the impacts of age, period, and cohort effects, and project the age-standardized prevalence rate and age-standardized incidence rates of femoral fractures from 2022 to 2036. MethodsUtilizing open data from the 2021 Global Burden of Disease (GBD) study, this research characterized the disease burden of femoral fractures in China between 1990 and 2021, including trends in incidence, prevalence, and years lived with disability (YLDs). Age-standardized rates were calculated, and Joinpoint regression models were employed to estimate annual percentage changes (APC) and average annual percentage changes (AAPC). An age-period-cohort (APC) model was applied to quantify the effects of age, period, and birth cohort on disease burden. A Bayesian age-period-cohort (BAPC) model was further utilized to project age-standardized prevalence rates and age-standardized incidence rates from 2022 to 2036, with stratified analyses by age, sex, and time period. ResultsFrom 1990 to 2021, age-standardized prevalence (AAPC=0.138 5%), incidence (AAPC=0.294 2%), and YLD rates (AAPC=0.128 3%) exhibited sustained upward trends. Unintentional injuries constituted the predominant etiology of femoral fractures, followed by transport accidents and interpersonal violence/self-harm. In 2021, disease burden escalated with advancing age, with females over 60 years demonstrating significantly higher burdens than males. Age effect coefficients showed a monotonic increase, period effects displayed a U-shaped trajectory (decline followed by rebound), and cohort effects exhibited an inverted U-shaped pattern (rise then decline). Projections indicated continued growth in age-standardized prevalence rates and age-standardized incidence rates through 2036. ConclusionAs the population aging intensifies in China, the disease burden of femoral fractures in our country remains extremely severe. Among them, the elderly female group has become the key focus for prevention and control due to the high prevalence of osteoporosis.