Hip Protectors

Hip fractures are an important cause of morbidity and mortality for those 65 years and older. They cause 20% of patients to require assistance in putting on pants, 66% in getting on and off the toilet, and 90% in climbing five stairs. The mortality rates range between 18-33%. Therefore, protective pads around the hip were introduced to disperse the impact of a fall and thus reduce the risk of fractures by shifting the energy away from the hip region. These pads fit into specially-designed pockets in undergarments or pants and are designed to be worn during the day when patients are out of bed and moving.

Evidence of Effectiveness:

Agostini and colleagues (2001) identified five studies on hip protectors and found that they appear to be effective in reducing the risk of hip fractures in older persons over 65 years of age. A recent study by Forsén and colleagues (2004) in seventeen nursing homes in Norway found that the odds of suffering a hip fracture for high risk residents was reduced to less than a third in protected falls compared with unprotected falls. However, the generalizability of these results to wider audiences and to lower risk populations has not been studied. As well, patients may experience discomfort from wearing the device, have difficulty managing the garment while dealing with incontinence, and there is potential for skin irritation and breakdown. Hip protectors are also costly, ranging from a quote of approximately $5.25 in an Australian study to a retail price quote by a U.S. manufacturer of about $90 per pair. The undergarments used to hold the devices also need special laundering and a tracking system, thus incurring more costs.

Todd and Skelton (2004) also summarized available evidence for hip protectors and found that hip protectors can substantially reduce hip fractures in residents but they do not affect the risk of falling nor do they reduce injury to any other part of the body. As well, the effectiveness of hip protectors depends on the model, correct placement and adherence. Hip protector use in residential care facilities in Denmark , (Lauritzen et al, 1993), England ( Birks et al, 2003) , Finland ( Kannus et al., 2000; Jantti et al., 2000) and the Netherlands ( Van Schoor et al, 2003) have shown a reduction in fracture rates, but more research is needed in warmer climates to evaluate adherence.

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