Hip Protectors May Prevent Fractures Less Than Half of the Time

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NEW YORK (Reuters Health) May 01 - The results of a study published in the April issue of the Journal of the American Geriatrics Society suggest that hip protectors have a maximum preventive potential of approximately 50% when used by older community-dwelling women or those living in homes for the elderly. And the actual protective rate may be lower.

"Hip protectors might lead to a marginal but statistically significant reduction in the incidence of hip fractures" in the elderly," Dr. Paul Lips, of VU University Medical Center, Amsterdam, and colleagues write. However, in the community-dwelling elderly, there is no evidence to support the efficacy of hip protectors, which might be explained by moderate adherence.

In an observational cohort study, the researchers estimated the maximum potential preventive effect of hip protectors in 299 community-dwelling subjects, who had already had a fracture and were at least 70 years old.

The researchers identified four factors that might influence the maximum potential protective effect of hip protectors: hip fractures in low-risk subjects; hip fractures unrelated to a fall; hip fractures in situations where a protector can't be used; and hip fractures at night.

The most common risk factors for hip fracture were: fracture since age 50; low body weight; and the presence of vertebral fracture. Just before the fracture occurred, 62.7% of women (n=138) and 7.6% of men (n=6) had an absolute 10-year risk of hip fracture of more than 10%.

The team estimated that 62.7% of women could have been offered hip protectors because they were at high risk according to the risk score of the Dutch Guidelines for Osteoporosis. "When providing hip protectors to women at high risk of fractures, 48.2% of all hip fractures could have been prevented," Dr. Lips and colleagues report.

The other half of fractures in this cohort could not have been prevented because they occurred in low-risk subjects or under circumstances that precluded the use of hip protectors.

Dr. Lips's group points out that the estimates were made based on the assumption that all of the subjects wore the hip protectors in the correct position each day. Therefore, the actual preventive effect would most likely be lower.

J Am Geriatr Soc 2007;55:507-510.

Source: http://www.medscape.com/viewarticle/555902?src=mp