Hip protectors prevent fractures in the elderly

BOSTON, Massachusetts (Reuters) -- Protectors that fit over the knobby end of the thigh bone can cut the risk of breaking a hip by 84 percent, according to a study in Thursday's New England Journal of Medicine.

In the United States, such protectors could eliminate up to 252,000 of the 300,000 hip fractures among the elderly. About one in four elderly people hospitalized for a hip fracture die within a year, either because of the fracture or its complications. Many of the survivors are permanently disabled.

"Hip protectors offer a powerful new method for reducing the risk of hip fracture," said Dr. Laurence Rubenstein of the Greater Los Angeles Veterans Affairs Medical Center. "Their use should be strongly encouraged for persons at increased risk ... and particularly for those residing in health care institutions, because they are likely to be frail."

Each protector, cupped like a hand and held in place by a stretchy undergarment, is designed to cover the greater trochanter, the knobby portion of the thigh bone that is next to the point there the thigh bone meets the pelvis. If a person falls, it sends the force of the impact away from the trochanter, protecting the hip.

A 1993 study published in the medical journal Lancet found that hip protectors prevented fractures in Danish nursing homes, but the devices have not been popular among the elderly and doctors have been waiting to see if the Danish study was just a fluke.

The New England Journal study, led by Dr. Pekka Kannus of the President Urho Kaleva Kekkonen Institute for Health Promotion Research in Tampere, Finland, "provides strong and timely confirmation of the efficacy of hip protectors in subjects at high risk for hip fractures," Rubenstein said in the Journal editorial.

Among the volunteers wearing hip protectors there were 1,034 falls, but only four hip fractures. When the volunteers weren't wearing the devices, the risk of suffering a broken hip was six times greater.

The main problem with the protectors was that many elderly people, even in the new study, found them inconvenient. "In our trial, 31 percent of the eligible subjects refused to wear the protector," the Kannus team said.

Rubenstein said "future research should focus on ways to improve the acceptability of hip protectors" and finding the patients who need them most.

The Kannus study included men and women at least 70 years old who were still able to get around by themselves but faced a high risk of a hip fracture because they had previously fallen, had recovered from an earlier fracture, had impaired balance, suffered from poor vision, or had a disease or were taking medication that made people prone to falling.

Copyright 2000 Reuters. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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National Osteoporosis Foundation
The American Geriatrics Society
The UKK Institute for Health Promotion Research

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