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Preventing Hip Fractures in the Elderly

This study evaluated the effect of wearing a hip protector on the incidence of hip fracture in the elderly. More than 1700 ambulatory men and women, aged 70 or older, from 22 community-based health care centers (residential or at-home care) were enrolled. Each subject had at least 1 of a predetermined list of risk factors for falls (e.g., use of certain drugs, cognitive impairment, previous fall or fracture). The mean age was 82; women outnumbered men by 3.5:1. Subjects were randomized to wear an undergarment that was padded at the hips or to usual care. The study was continued until 1 month after 62 fractures had been detected in the control group; the average follow-up was about 1 year.

Despite numerous dropouts and refusals to participate in both groups, and a high rate of noncompliance (31 percent) in the hip protector group, the rate of hip fracture was 54 percent lower in the hip protector group than in the control group. After the authors took into account whether the hip protector was being worn at the time of the fall, the difference increased to 84 percent. The authors calculated that only 41 people would need to wear a hip protector to prevent 1 hip fracture during the course of 1 year.

Comment: This study presents us with a striking opportunity for injury prevention. Offering a hip protector to each elderly patient seen because of a fall should prove an easy intervention to implement.

— JS Bohan

Published in Journal Watch Emergency Medicine January 4, 2001

Citation(s):

Kannus P et al. Prevention of hip fracture in elderly people with use of a hip protector. N Engl J Med 2000 Nov 23 343 1506-1513.

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