Hip protector

AHIP Protector

A hip protector is a specialized form of pants or underwear containing pads (either hard or soft) along the outside of each hip/leg, designed to prevent hip fractures following a fall. They are most commonly used in elderly individuals who have a high risk of falls and hip fractures (for example, due to history of a previous fall and underlying osteoporosis).[1]

Most hip fractures follow an impact due to a lateral fall.[2] The pads are located over the trochanters, the bony extrusions of the hip region.

Effectiveness

A 2014 Cochrane review found that hip protectors decrease the number of hip fractures among the elderly.[3]

A previous review found that the effect for preventing hip fracture among nursing home residents was small and not effective among community dwelling elderly individuals.[4] A 2007 review found a decreased risk of hip fractures in elderly nursing home residents.[5]

However, acceptance and long-term compliance towards them is quite low,[4] mainly because of discomfort, dislike of their appearance by the person wearing it, and disagreement about fracture risk.[6]

Research which has found hip protectors to be beneficial found that hard, energy-shunting hip protectors to be superior to soft, energy-absorbing ones.[7] Another study showed that hip protectors' design and mechanical properties vary drastically among commercially available hip protectors.[8]

Types

Hip protectors are either of the "crash helmet type" or "energy-absorbing type". The "crash helmet type" distributes impacts into the surrounding soft tissue, while the "energy-absorbing type" is made of a compressible material and diminishes the force of impact. Both of these systems aim to reduce the focused force beneath an estimated fracture threshold.[1][9]

Several different commercially available hip protectors exist, such as the GeriHip (Prevent Products, Inc.,USA), Impactwear Hip Protective Garments (High Tech Bodywear Ltd., New Zealand), Lyds Hip Protector (Lyds International BV, The Netherlands), Safety Pants (Raunomo Oy, Finland), Safehip (Tytex A/S, Ikast, Denmark), the AHIP Protector (Astrotech, Vienna, Austria) and the KPH hip protector (HRA Pharma, Paris, France).[1][7]

The former has been used in most clinical trials.[10] Hip protectors have the advantage of having no important adverse effects.[4]

Footnotes

  1. ↑ 1.0 1.1 1.2 Holzer, G; Holzer, LA (2007). "Hip protectors and prevention of hip fractures in older persons". Geriatrics 62 (8): 15–20. PMID 17668960.
  2. ↑ Lauritzen, JB (1996). "Hip fractures: incidence, risk factors, energy absorption, and prevention". Bone 18 (1 Suppl): 65S–75S. doi:10.1016/8756-3282(95)00382-7. PMID 8717550.
  3. ↑ Santesso, N; Carrasco-Labra, A; Brignardello-Petersen, R (Mar 31, 2014). "Hip protectors for preventing hip fractures in older people.". The Cochrane database of systematic reviews 3: CD001255. doi:10.1002/14651858.CD001255.pub5. PMID 24687239.
  4. ↑ 4.0 4.1 4.2 Parker, MJ; Gillespie, WJ; Gillespie, LD (2006). "Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review". BMJ (Clinical research ed.) 332 (7541): 571–4. doi:10.1136/bmj.38753.375324.7C. PMC 1397761. PMID 16513687.
  5. ↑ Sawka, AM; Boulos, P; Beattie, K; Papaioannou, A; Gafni, A; Cranney, A; Hanley, DA; Adachi, JD et al. (2007). "Hip protectors decrease hip fracture risk in elderly nursing home residents: a Bayesian meta-analysis". J Clin Epidemiol 60 (4): 336–44. doi:10.1016/j.jclinepi.2006.07.006. PMID 17346606.
  6. ↑ Patel, S; Ogunremi, L; Chinappen, U (2003). "Acceptability and compliance with hip protectors in community-dwelling women at high risk of hip fracture". Rheumatology (Oxford, England) 42 (6): 769–72. doi:10.1093/rheumatology/keg215. PMID 12730537.
  7. ↑ 7.0 7.1 van Schoor, N.M.; Van Der Veen, A.J.; Schaap, L.A.; Smit, T.H.; Lips, P. (2006). "Biomechanical comparison of hard and soft hip protectors, and the influence of soft tissue". Bone 39 (2 Suppl): 401–407. doi:10.1016/j.bone.2006.01.156. PMID 16546458.
  8. ↑ Holzer, LA; Von Skrbensky, G; Holzer, G (2009). "Mechanical testing of different hip protectors according to a European Standard". Injury 40 (11): 1172–5. doi:10.1016/j.injury.2009.02.005. PMID 19524913.
  9. ↑ Holzer, LA; Holzer, G (2007). "Design: A neglected factor in medicine". McGill journal of medicine : MJM : an international forum for the advancement of medical sciences by students 10 (1): 3. PMC 2323546. PMID 18523599.
  10. ↑ Lin, JT; Lane, JM (2008). "Nonpharmacologic management of osteoporosis to minimize fracture risk". Nature Clinical Practice Rheumatology 4 (1): 20–5. doi:10.1038/ncprheum0702. PMID 18172445.