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Osteoporosis and Hip Fracture

For osteoporosis sufferers, those with low Bone Mineral Density, but primarily the frail and elderly, falling on the hip and breaking the femur results in one of the most expensive operations undertaken by the NHS, with a typical stay in hospital of over 20 days. Often, a further period in a nursing home is required for the patient to recover, and in a significant minority of cases the consequences can be even more tragic. But even if the patient does make a full recovery, mobility is usually reduced and a 'fear of falling' often impairs the quality of their life.

Numerous studies have established that the current generation of hip protectors are unsatisfactory, mostly because they are too uncomfortable to wear for any length of time, especially at night, when many accidents occur.

Nearly 75% of all hip fractures occur in women1 and about 25% of hip fractures in people over 50 occurs in men2. Hip fractures are invariably associated with chronic pain, reduced mobility, disability, and an increasing degree of dependence3. After sustaining a hip fracture 10-20% of formerly community dwelling patients require long term nursing care4, 5, 6, with the rate of nursing home admission rising with age5, 7

. A 50 year-old woman has a 2.8% risk of death related to hip fracture during her remaining lifetime, equivalent to her risk of death from breast cancer and 4 times higher than that from endometrial cancer8. Approximately 1.6 million hip fractures occur worldwide each year; by 2050 this number could reach between 4.5 million9 and 6.3 million2. 5-10% of patients experience a recurrent hip fracture10, 11, with the mean interval between the first and second fracture being 3.3 years11. Hip fractures cause the most morbidity with reported mortality rates up to 20-24% in the first year after a hip fracture12, 13, and greater risk of dying may
persist for at least 5 years afterwards
14. Loss of function and independence among survivors is profound, with 40% unable to walk independently, 60% requiring assistance a year later15. Because of these losses, 33% are totally dependent or in a nursing home in the year following a hip fracture13, 16, 17. Hip fractures account for a larger proportion of all fracture expenditures in men than women (73% vs. 61%). Overall, 23% of hip fracture expenditure occurs in men18.

 

1. Jordan KM and Cooper C (2002) Epidemiology of osteoporosis. Best Pract Res Clin Rheumatol 16:795

2. Cooper C, Campion G, Melton LJ, 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285.

3. Keene GS, Parker MJ, Pryor GA (1993) Mortality and morbidity after hip fractures. BMJ 307:1248.

4. Autier P, Haentjens P, Bentin J, et al. (2000) Costs induced by hip fractures: a prospective controlled study in Belgium. Belgian Hip Fracture Study Group. Osteoporos Int 11:373.

5. Cree M, Soskolne CL, Belseck E, et al. (2000) Mortality and institutionalization following hip fracture. J Am Geriatr Soc 48:283.

6. Kiebzak GM, Beinart GA, Perser K, et al. (2002) Undertreatment of osteoporosis in men with hip fracture. Arch Intern Med 162:2217.

7. Reginster JY, Gillet P, Ben Sedrine W, et al. (1999) Direct costs of hip fractures in patients over 60 years of age in Belgium. Pharmacoeconomics 15:507.

8. Cummings SR, Black DM, Rubin SM (1989) Lifetime risks of hip, Colles', or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med 149:2445.

9. Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407.

10. Madhok R, Melton LJ, 3rd, Atkinson EJ, et al. (1993) Urban vs rural increase in hip fracture incidence. Age and sex of 901 cases 1980-89 in Olmsted County, U.S.A. Acta Orthop Scand 64:543.

11. Schroder HM, Petersen KK, Erlandsen M (1993) Occurrence and incidence of the second hip fracture. Clin Orthop Relat Res Apr;(289):166.

12. Cooper C, Atkinson EJ, Jacobsen SJ, et al. (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001.

13. Leibson CL, Tosteson AN, Gabriel SE, et al. (2002) Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study. J Am Geriatr Soc 50:1644.

14. Magaziner J, Lydick E, Hawkes W, et al. (1997) Excess mortality attributable to hip fracture in white women aged 70 years and older. Am J Public Health 87:1630.

15. Magaziner J, Simonsick EM, Kashner TM, et al. (1990) Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol 45:M101.

16. Riggs BL and Melton LJ, 3rd (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17:505S.

17. Kannus P, Parkkari J, Niemi S, Palvanen M (1996) Epidemiology of osteoporotic ankle fractures in elderly persons in Finland. Ann Intern Med 125:975.

18. Center JR, Nguyen TV, Schneider D, et al. (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878.

 

 
 

What Our Users Are Saying..

Bernadette Taylor
2016-04-26, 10:45
Dear William,

The hip protectors are great and we like the new material in the underpants.

Thanks again, Bernadette
Geoffrey Hampden-Smith
2016-04-26, 10:39
Dear William. Your package arrived very promptly several days ago. Thank you very much. I am wearing the hip protectors while recuperating from a fall - with the prognosis of a month on crutches. They are very, very comfortable and not noticeable under my track suit. Wearing the pants with the protectors gives me the confidence to do more on crutches and I am hoping that this this will accelerate my re-habilitation.

I am 67 years old and still work in a boatyard. I just wish I was aware of … read more