Background: Hip fractures are common in frail elderly adults worldwide. We
investigated the effect of an anatomically designed external hip protector
on the risk of these age-related fractures.
Methods: We randomly assigned 1801 ambulatory but frail elderly adults (140
9 women and 392 men; mean age, 82 years), in a 1:2 ratio, either to a group
that wore a hip protector or to a control group. Fractures of the hip and
all other fractures were recorded until the end of the first full month aft
er 62 hip fractures had occurred in the control group. The risk of fracture
in the two groups was compared, and in the hip-protector group the risk of
fracture was also analyzed according to whether the protector had been in
use at the time of a fall.
Results: During follow-up, 13 subjects in the hip-protector group had a hip
fracture, as compared with 67 subjects in the control group. The respectiv
e rates of hip fracture were 21.3 and 46.0 per 1000 person-years (relative
hazard in the hip-protector group, 0.4; 95 percent confidence interval, 0.2
to 0.8; P=0.008). The risk of pelvic fracture was slightly but not signifi
cantly lower in the hip-protector group than in the control group (2 subjec
ts and 12 subjects, respectively, had pelvic fracture) (relative hazard, 0.
4; 95 percent confidence interval, 0.1 to 1.8; P greater than or equal to 0
.05). The risk of other fractures was similar in the two groups. In the hip
-protector group, four subjects had a hip fracture (among 1034 falls) while
wearing the protector, and nine subjects had a hip fracture (among 370 fal
ls) while not wearing the protector (relative hazard, 0.2; 95 percent confi
dence interval, 0.05 to 0.5; P=0.002).
Conclusions: The risk of hip fracture can be reduced in frail elderly adult
s by the use of an anatomically designed external hip protector. (N Engl J
Med 2000;343:1506-13.) (C) 2000, Massachusetts Medical Society.