Nov. 22, 2000 -- Hip fractures, a common cause of disability and even death in elderly people, are notoriously hard to prevent. But there may be a solution available for some people. A study in the Nov. 23, 2000 issue of The New England Journal of Medicine says that a device called a hip protector is very effective in preventing these fractures if it is worn regularly.
In this study researchers used a modern hip protector, with a shaped protective shield that fits over the hipbone, surrounded by padding, held in place by a stretchy undergarment. "This study is the first to show ... that the risk of hip fracture among the elderly can indeed be reduced by the regular use of hip protectors," study author Pekka Kannus, MD, PhD tells WebMD.
Kannus, a professor of injury prevention at the University of Tampere, and head of the Accident and Trauma Research Center at the UKK Institute in Tampere, Finland, adds "The device used in this study is quite comfortable to wear."
However, "they're a hard sell," says Judy Stevens, PhD, an epidemiologist in the National Center of Injury Prevention and Control, in Atlanta. "Just imagine asking any woman to wear something that's going to make her hips look bigger!"
"No one wants to walk around wearing a device that makes their hip size increase," Chhanda Dutta, PhD, tells WebMD. "Now researchers are working to develop thin, lightweight materials that can also absorb more force." Dutta, the director of musculoskeletal research in the geriatrics program at the National Institute on Aging, says there is a great deal of interest in this subject these days. "We can expect to see more sophisticated methods of hip protection tested during the next few years."
Stevens, who has tried two modern hip protectors, agrees. "They're not bad. I was surprised they were so comfortable."
In this study researchers compared the risk of hip fractures among people wearing hip protectors and similar people not wearing hip protectors. They found that wearing hip protectors cut a person's risk of getting a hip fracture by more than half. When they looked at the rate of fractures per fall, they found a fracture was more than 80% less likely if someone was wearing a protector at the time of the fall.
"We are terribly concerned about hip fracture in the elderly," Irving P. Ratner, MD, tells WebMD. "This sort of hip protection is an excellent idea, whose time has come. Hip protectors will probably avoid the need for surgery and save some patients from injury and even death." Ratner is the immediate past president of the Medical Society of New Jersey and an orthopaedic surgeon in private practice in Burlington, N.J.
The people who are most likely to fall and break a hip are the very old, Kannus says. "If you are independent and able to get around, you don't need a hip protector. But if someone has problems with balance, or has already fallen repeatedly, that person or their caregivers should seriously think about using a hip protector."
In addition to using hip protectors, there are several practical steps people can take to prevent falls and hip fractures, Stevens tells WebMD. "Exercise is the single most effective thing, because it increases muscular strength and balance." Next, check to be sure the home has adequate lighting, with grab bars in the bathroom and railings on both sides of the stairs. Get rid of throw rugs.
To lower the risk of falls, people over 65 should wear lace-up shoes with thin, non-slip soles, Stevens says. "Thick soles are a hazard because you can't really feel the floor."
Finally, a doctor or other health professional should review ALL the medications the person is taking, to be sure the dosages are appropriate. Sometimes interactions between two medications can cause drowsiness or dizziness that can lead to falls.