458 Limited benefit from hip protectors

July 02, 2015

written by Brian R McAvoy

Clinical question
How effective are hip protectors in preventing fractures in older people?

Bottom line
In older people living in nursing care facilities, providing a hip protector decreased the chance of a hip fracture slightly (11 fewer per 1000 people), may have increased the small chance of a pelvic fracture slightly (1 more per 1000 people) and probably had little or no effect on other fractures or falls. For those living at home, providing a hip protector probably had little or no effect on hip fractures. The incidence of adverse events while wearing hip protectors, including skin irritation, ranged from 0–5%. Adherence, particularly in the long term, was poor.

Caveat
The quality of evidence for most outcomes was of moderate or low quality primarily due to risk of bias and imprecise results because of few fracture events.

Context
Older people living in nursing care facilities or older adults living at home are at high risk of falling, and a hip fracture may occur after a fall. Hip protectors have been advocated as a means to reduce the risk of hip fracture.

Cochrane Systematic Review
Santesso N et al. Hip protectors for preventing hip fractures in older people. Cochrane Reviews, 2014, Issue 3. Art. No.: CD001255.DOI: 10.1002/14651858. CD001255.pub5. This review contains 19 studies involving approximately 17,000 participants (mean age range 78–86 years).

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.