DOCTOR'S VIEW ARCHIVE
Medical Author: William C. Shiel Jr., MD, FACP, FACR
Breaking the bones of the hip (hip fracture) is common in the elderly. This is a result of two major factors that affect older people: (1) an increased risk of falling because of poor stability (from a decrease in muscle, joint, and nerve function) and poor vision; and (2) weak bones that break easily because of osteoporosis.
It has been estimated that 250,000 (a quarter of a million) people in the United States suffer hip fractures each year!
A hip fracture is a terrible injury. It typically requires major surgery for repair. Operations involve either metal pinning with screws and/or plates or replacement of the hip joint with artificial parts. These operations can be complicated by infections, blood clotting, bleeding, and failure of the repair work. After such a surgical procedure, long and aggressive rehabilitation programs are necessary for optimal success. For the very frail, elderly person, ultimate recovery can be extremely difficult and long-term loss of independence, nursing-home placement, and even death can result.
Prevention of hip fractures is a key part of caring for the health of the elderly. Elderly people can take measures to decrease their own risk for hip fractures. These measures include participating in regular, proper exercise, "clearing the runway" in homes for walking and transferring, undergoing regular general and eye-health checkups, and addressing osteoporosis (bone-density exams, calcium and vitamin D intake, and osteoporosis medications when indicated).
A new means of helping to prevent hip fractures is an external hip protector. A hip protector is an external garment that looks like a slip-on girdle. It has padded protector shields that slide into pockets over the bony prominence of the side of the hips. The protector is designed to shunt the energy of an impact away from the bony prominence of the hip to the surrounding tissues.
Researchers have found that among walking elderly adults, the risk of hip fracture can be reduced by 80% if a hip protector is worn at the time of a fall. It seems that hip protectors can make a big difference for the elderly in preventing hip fractures.
The doctor-editors at MedicineNet.com encourage those elderly people who are at risk of a hip fracture to consider the use of a hip protector. We recognize that more study is needed to further classify people at risk and to determine the optimal make and models of hip protectors. (When this editor used an advanced search of Yahoo! for "hip protectors," he found 1,000 Web sites!)