Hip protectors are cost-effective in the prevention of hip fractures in patients with high fracture risk

Bot, Robin T A L de; Veldman, Hidde D.; Witlox, Adhiambo M.; Rhijn, Lodewijk W. van; Hiligsmann, Mickaël

doi:10.1007/s00198-019-05252-8

Cited by 20 publications

(17 citation statements)

References 67 publications

(220 reference statements)

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“…A systematic review undertaken by de Bot et al concluded that the use of hip protectors in an elderly population at high risk for hip fractures, such as nursing home residents or patients in a geriatric ward in a hospital, was a cost-effective approach to preventing hip fractures [ 9 ]. Another study performed by Singh et al found that the use of hip protectors was a more cost-effective method compared to no treatment or the use of calcium and vitamin D supplements [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

A Description of Novel Uses of Hip Protectors in an Elderly Hip Fracture Population: A Technical Report

Nolan¹,

Tiedt²,

Ellanti³

et al. 2022

Cureus

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Hip fractures are a significant cause of morbidity and mortality in the elderly population. The number of hip fractures is set to increase significantly by 2050 as the global population ages. The costs associated with hip fracture patients are significant due to prolonged hospitalisation and rehabilitation. Hip protectors have been advocated as a strategy to reduce the risk of hip fractures in a high-risk population. Evidence suggests that hip protectors are a cost-effective method for reducing the risk of hip fractures. There have, however, been issues with adherence with wearing hip protectors amongst patients and healthcare staff. Despite prevention strategies, many patients continue to present with hip fractures. Many of these patients have cognitive impairment or experience peri-operative delirium. This can cause issues with patients' interference with the operative wound and presents a significant burden to the healthcare team with the need for increased wound monitoring and care in the post-operative period. Applying a well-fitted hip protector provides a substantial additional barrier to protect the surgical wound. Hip fracture surgical wounds can be difficult to manage in these patients and our standard post-operative protocol is to apply compression dressings in this group of patients. We have found that a well-fitted hip protector can provide adequate compression to the surgical site. We describe a brief technical report on a novel use of hip protectors in providing wound security in the agitated patient post-operatively as well as a method of providing compression to the surgical wound site.

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Section: Discussionmentioning

confidence: 99%

A Description of Novel Uses of Hip Protectors in an Elderly Hip Fracture Population: A Technical Report

Nolan¹,

Tiedt²,

Ellanti³

et al. 2022

Cureus

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“…2 Approximately 30,000 hip fractures occur each year in Canada 3 and more than 90% of hip fractures are attributable to falls. 4 There are a number of risk factors associated with hip fractures such as female gender, older age, low cognitive function, and previous spine or hip fracture. 4 There are several interventions that aim to reduce the number of hip fractures in older adults.…”

Section: Context and Policy Issuesmentioning

confidence: 99%

“…4 There are a number of risk factors associated with hip fractures such as female gender, older age, low cognitive function, and previous spine or hip fracture. 4 There are several interventions that aim to reduce the number of hip fractures in older adults. These include regular exercise, pharmacological treatments (e.g., calcium, vitamin D), and the use of hip protectors.…”

Section: Context and Policy Issuesmentioning

confidence: 99%

“…These include regular exercise, pharmacological treatments (e.g., calcium, vitamin D), and the use of hip protectors. 4 There are 2 main types of hip protectors that include either hard shells or soft pads that are usually held within specifically designed underwear. 5 The purpose of hip protectors is to either shunt or absorb the force of impact to prevent fractures.…”

Section: Context and Policy Issuesmentioning

confidence: 99%

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Hip Protectors for Community-Dwelling Older Adults

Farrell¹,

Walter²

2021

cjht

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In community-dwelling older adults who wore hip protectors there was no difference in the risk of hip fractures or pelvic fractures, compared to those who did not wear hip protectors. Three guidelines were identified that include recommendations around the use of hip protectors in older adults. One guideline suggests that hip protectors should be considered in adults at risk for falls and hip fracture. One guideline conditionally recommends hip protectors for frail older adults in the appropriate environment. One guideline suggests that hip protectors should not be considered in older adults in community settings.

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“…Intertrochanteric fractures are common injuries in elderly, with estimated prevalence of intertrochanteric fractures greater than 150,000 cases in the USA annually [ 1 , 2 ]. Patients with intertrochanteric fractures always have a history of falls or bone disease, which might be due to a low-energy mechanism including fall from standing [ 3 , 4 ]. Further, the typical clinical manifestations include pain and difficulty walking.…”

Section: Introductionmentioning

confidence: 99%

Optimal surgical methods to treat intertrochanteric fracture: a Bayesian network meta-analysis based on 36 randomized controlled trials

Cheng

Sheng

2020

J Orthop Surg Res

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Background There are several surgical methods to treat intertrochanteric fracture: dynamic hip screw (DHS), compression hip screw (CHS), percutaneous compression plate (PCCP), Medoff sliding plate, less invasive stabilization system (LISS), Gamma nail, proximal femoral nail (PFN), and proximal femoral nail anti-rotating (PFNA). We therefore conducted a network meta-analysis to compare eight surgical interventions, including DHS, CHS, PCCP, Medoff sliding plate, LISS, Gamma nail, PFN, and PFNA, to provide the optimal surgical intervention for intertrochanteric fracture. Methods An electronic search of 4 databases (PubMed, Embase, Cochrane library, and Web of Science) from inception to July 2020. Two or more of the eight surgical interventions, including the DHS, CHS, PCCP, Medoff sliding plate, LISS, Gamma nail, PFN, and PFNA, for intertrochanteric fracture were included. The methodological quality of the included studies was assessed using the Cochrane Collaboration risk of bias (ROB) tool. Network meta-analysis was conducted by using R-3.5.1 software with the help of package “gemtc”. The odd ratios (ORs) with 95% credibility interval (CrI) were used to assess complications and standard mean difference (SMD) with 95% CrI to calculate the continuous outcomes (operative time, intraoperative blood loss, and Harris hip score). Surfaces under the cumulative ranking curves (SUCRA) were used to rank the intervention. Results A total of 36 RCTs were included in this study. The results of this network meta-analysis showed that, compared with the CHS and DHS group, PFNA exhibited a beneficial role in reducing the blood loss (SMD, 152.50; 95% CrI, 72.93 to 232.45; and SMD, 184.40; 95% CrI, 132.99 to 235.90, respectively). PFNA achieved the lowest value for the surface under the cumulative ranking curve (SUCRA) for the blood loss (SURCA = 0.072) and highest of Harris hip score (SURCA = 0.912). PCCP may have the lowest probability of the operative time (SURCA = 0.095). There were no significant differences among the eight surgical procedures in complications. Conclusion PFNA technique is the optimal treatment method for intertrochanteric fracture. Larger, longitudinal RCTs addressing current limitations, including sources of bias, inconsistency, and imprecision, are needed to provide more robust and consistent evidence.

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Hip protectors are cost-effective in the prevention of hip fractures in patients with high fracture risk

Cited by 20 publications

References 67 publications

A Description of Novel Uses of Hip Protectors in an Elderly Hip Fracture Population: A Technical Report

A Description of Novel Uses of Hip Protectors in an Elderly Hip Fracture Population: A Technical Report

Hip Protectors for Community-Dwelling Older Adults

Optimal surgical methods to treat intertrochanteric fracture: a Bayesian network meta-analysis based on 36 randomized controlled trials

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