Hip protectors prevent fractures

When you’re older, a fall on icy winter streets is no small matter. It can be the beginning of the end of independent life. Hip fractures are one of the most devastating problems commonly faced by elderly people.Thousands are hospitalized each year in Canada because of hip fractures. Those who do recover from the fracture often face a reduction in their ability to walk and function in daily life.

Many smaller problems can lead to a fall-muscle weakness, poor vision and poor balance. Sometimes, diseases such as arthritis and osteoporosis can contribute to a lack of strength and balance. Alcohol and certain medications can also make people less steady on their feet. And in Canada, ice and snow underfoot in the winter add to the risk.

Prevention is key
Prevention is clearly the best solution.

The answer may lie in Finland. A recent study published in the New England Journal of Medicine confirmed that hip protectors offer a powerful new method for reducing the risk of hip fracture. Dr. Laurence Rubenstein, of the Greater Los Angeles Veterans Affairs Medical Centre, says their use “should be strongly encouraged for perso at increased risk.”

People with increased risk of hip fracture include those with osteoporosis and a high risk of falling, such as those with unsteady walking and muscle weakness. The protectors are particularly suited for those living in health care institutions, since they are likely to be frail.

Hip protector study
The Finnish study took a large-scale look at the effects of hip protectors. The trial involved subjects 70 years old or older, who had one or more risk factors for hip fracture. These risks included such things as a previous fall or fracture, impaired balance or mobility, use of walking aids, or cognitive impairment.

About two thirds of the subjects were residents of health care centres. The balance lived in their own homes, supported by a home-care program.

The hip protectors prevented fractures:

• The rate of hip fracture per fall was 84 per cent lower when the hip protectors were being worn.
• The overall rate of hip fracture in the hip-protector group was 54 per cent lower than that in the control group.
• This lower rate is due to some subjects not wearing their hip protector at the time of a fall.

The study didn’t look at the cost effectiveness of providing hip protectors. But it is definitely a small price to pay compared to the cost of treating a hip fracture. According to the authors’ calculations, only 41 persons need be offered a hip protector to prevent one hip fracture.

There are other, less obvious benefits as well. In a recent Australian study, hip protectors improved the self-confidence of frail subjects and led to improved mobility and daily function. The growing attention to the prevention of falls is an important change in health care for the elderly. The message is that falling does not have to be a natural part of aging.