Kannus P, Parkkari J, Niemi S, Pasanen M, Palvanen M, Järvinen M, Vuori I
Accident and Trauma Research Center, President Urho Kaleva Kekkonen Institute for Health Promotion Research, Tampere, Finland.
N Engl J Med. 2000 Nov 23;343(21):1506-13. doi: 10.1056/NEJM200011233432101.
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.
We randomly assigned 1801 ambulatory but frail elderly adults (1409 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 after 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.
During follow-up, 13 subjects in the hip-protector group had a hip fracture, as compared with 67 subjects in the control group. The respective 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 significantly lower in the hip-protector group than in the control group (2 subjects and 12 subjects, respectively, had pelvic fracture) (relative hazard, 0.4; 95 percent confidence interval, 0.1 to 1.8; P > or = 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 falls) while not wearing the protector (relative hazard, 0.2; 95 percent confidence interval, 0.05 to 0.5; P=0.002).
The risk of hip fracture can be reduced in frail elderly adults by the use of an anatomically designed external hip protector.
髋部骨折在全球体弱的老年人中很常见。我们研究了一种解剖学设计的外部髋部保护器对这些与年龄相关骨折风险的影响。
我们将1801名能走动但体弱的老年人（1409名女性和392名男性；平均年龄82岁）按1:2的比例随机分为佩戴髋部保护器组或对照组。记录髋部骨折和所有其他骨折情况，直至对照组发生62例髋部骨折后的第一个完整月末。比较两组的骨折风险，在髋部保护器组中，还根据跌倒时保护器是否在使用来分析骨折风险。
随访期间，髋部保护器组有13名受试者发生髋部骨折，而对照组有67名受试者。髋部骨折的发生率分别为每1000人年21.3例和46.0例（髋部保护器组的相对风险为0.4；95%置信区间为0.2至0.8；P = 0.008）。髋部保护器组骨盆骨折的风险略低于对照组，但无显著差异（分别有2名和12名受试者发生骨盆骨折）（相对风险为0.4；95%置信区间为0.1至1.8；P≥0.05）。两组其他骨折的风险相似。在髋部保护器组中，有4名受试者在佩戴保护器时（1034次跌倒中）发生髋部骨折，9名受试者在未佩戴保护器时（370次跌倒中）发生髋部骨折（相对风险为0.2；95%置信区间为0.05至0.5；P = 0.002）。
使用解剖学设计的外部髋部保护器可降低体弱老年人髋部骨折的风险。
