Clinical Risk Assessment, Interventions and Service |
Prevention of hip fracture with hip protectors
1 Accident & Trauma Research Center, UKK Institute for Health Promotion Research, Tampere, Finland
2 Department of Surgery, Tampere University Medical School and University Hospital, Tampere, Finland
3 Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
Address correspondence to: P. Kannus, UKK Institute, PO Box 30, FIN-33501 Tampere, Finland. Tel: (+358) 3 282 9336; Fax: (+358) 3 282 9200. Email: pekka.kannus{at}uta.fi
The prevention of fractures amongst older people consists of (i) prevention and treatment of osteoporosis, (ii) prevention of falling and (iii) prevention of fractures using injury-site protection. As the great majority of hip fractures are caused by a sideways fall with direct impact on the greater trochanter of the proximal femur, one approach to prevention is the use of an adequately configured padded, firm-shield external hip protector. With this type of two-part design, the impacting force and energy are, at the time of the fall-impact, first weakened by the padding part of the protector and then diverted away from the greater trochanter by the shield part of the same. Following this line, a series of consecutive studies by the Accident & Trauma Research Center at the UKK Institute, Tampere, Finland, found that a padded, strong-shield hip protector was effective in preventing hip fractures. In the context of the wider literature on hip protectors, these more encouraging results suggest the need for a more rigorous regulation of protector design and characteristics. Alongside inadequacies of design, the other most frequent general problem with hip protectors is compliance. Not all elderly people with a high risk of hip fracture will agree to use hip protectors and in those who do, long-term adherence may decrease. Caregiver motivation and involvement appear therefore to be crucial.
Keywords: hip fracture, hip protector, prevention