[Prevention of fractures and the use of hip protectors in the elderly: it is still too early for recommendations].

Hip fractures are a major health problem in the elderly. Several measures may reduce the number of hip fractures: prevention of falls, improving bone quality, and reducing the impact on the hip region during a fall; external hip protectors can be useful in this respect. Cluster-randomised studies have shown a significant reduction of hip fractures by 50% in elderly people wearing hip protectors who live in old-age homes or nursing homes and run an increased risk of falling. However, there is no evidence of a decreased number of hip fractures in studies in which individual randomisation was used. For elderly people living independently at home, there are still insufficient data on the effectiveness of hip protectors. An important problem with the use of hip protectors is the treatment compliance, which is generally very low. Many of the fractures in the intervention groups in published trials occurred at a time at which the protectors were not being worn. At present, there is too little evidence to decide definitely whether or not the use of hip protectors is useful.