Hip Fracture Prevention
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Hip Fracture Prevention

PD_Seniors_SEN100 This is one of the best ideas I've seen in a long time: A way to prevent hip fractures that's simple, easy-to-use, effective, inexpensive, and immediate. It's called a hip protector. Two pads, one over each hip joint, are worn inside a fitted undergarment—similar to a pair of biking shorts—that holds them in place. Wearing these hip pads helps absorb the impact that otherwise would go directly to your hip joints if you fall.

That's extremely important. Each year in the US over 300,000 people 65 years old or older break a hip. About a quarter of them die within a year from complications of the fracture. Of those that survive, most have more difficulty walking or taking care of themselves than before the injury, and half cannot live independently.

Much of this death and disability could be avoided, however, with prevention. In addition to reducing falling hazards and keeping your hips strong with diet, exercise, and drugs for bone strength, the hip protectors can provide a powerful option for averting hip fractures.

A Breakthrough in Fracture Prevention

Study results published in the New England Journal of Medicine confirmed that hip protectors are a very effective way to prevent hip fractures. The study followed 1801 Finnish women and men aged 70 and older who had at least one risk factor for hip fracture. The participants could walk with or without assistance and lived in a nursing home or at their own home, supported by a homecare program.

By the end of the study only 13 people in the hip-protector group had a hip fracture compared with 67 people in the control group—a 60% reduction in hip fractures. After correcting for the fact that some people in the hip-protector group were not wearing their protectors when they fell, researchers calculated a more than 80% decrease in fractures when the pads were worn.

These findings verify earlier but similar results. Previous research in The Lancet studied nursing home residents in Denmark who could walk. After 11 months of follow-up, the hip-fracture rate was 53% lower in the hip-protector group. Even more impressive was the fact that none of the people who broke a hip were wearing hip protectors when they fell.

Willingness to Comply

This brings up a vital point. A hip protector doesn't do you any good if it's left lying in your drawer. To be effective, you have to actually wear it. Unfortunately, many people who could benefit are unwilling to wear the protectors or are not sufficiently motivated to wear them consistently.

The trend, however, is for improvement. A number of companies around the world are working to refine the comfort and convenience features of hip protectors. And, as people become better educated about the devices, we will see more in use.

In the meantime, there is another aspect of hip pads that might inspire some people to give them a try. Recent research shows the protectors can improve quality of life in older people who curtail normal activities because of fear of falling or breaking a hip. A study of frail individuals in Australia found those who regularly wore the devices had notable improvements in their self-confidence, mobility, and function.

Buying Hip Protectors

When used properly, the padded, rounded, plastic shields must fit securely in the side pockets of a specially designed undergarment. The design of most hip protectors on the market makes them fairly easy to wear under a skirt or pants without hampering movement. You can purchase protectors at some medical-supply stores or by mail order. According to Consumer Reports, the price ranges from $70 to $90, which is not covered by insurance. However, you can search the internet to find various companies that sell hip protectors for as little as $30 or as much as $500, depending on the quality and size.

Risk Factors for Hip Fracture

While hip protectors are simple and effective, not everyone needs a pair. Experts generally recommend the devices for older people at high risk for breaking a hip. Your susceptibility is increased if you have a disease that makes your bones brittle such as osteoporosis. It's also higher if you have factors that make falling more likely, including:

  • A previous fall or fracture
  • Poor mobility, balance, or coordination
  • Use of a walking aid such as a cane
  • Problems with memory or vision
  • Fragile health, weakness, or poor nutrition
  • Chronic disease, such as arthritis, Parkinson's disease, or stroke
  • Irregular heart beat or low blood pressure
  • Drugs that cause dizziness, drowsiness, or weakness

For people at increased risk, hip protectors are an idea whose time has come.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org

National Center for Injury Prevention and Control
http://www.cdc.gov/ncipc

National Institute of Arthritis and Musculoskeletal and Skin Diseases
www.nih.gov/niams

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org/

Canadian Orthopaedic Foundation
http://www.canorth.org/

REFERENCES

Hip protectors: a breakthrough in fracture prevention. NEJM. 2000 Nov 23;343(21):1562-1563.

Pads, exercise counter fear of falling. Consumer Reports On Health. 2001 Apr; p.10.

Prevention of hip fracture in elderly people with use of a hip protector. NEJM. 2000 Nov 23; 343(21):1506-1513.



Last reviewed January 2008 by Rosalyn Carson-DeWitt, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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