Just occasionally, a little study comes along that supports a gut feeling. One of my most
memorable teaching sessions was when someone reminded me to listen to the patient. "At least
half those coming in who can give a sensible history with a hip fracture will tell you they fell
because the hip gave way, not that they fell and then the hip broke."
And indeed they do.
This study in JAMA 2003:289;1957-62 reported as a POEM in the BMJ last week is not quite
powerful enough to find a significant difference statistically, but the trend was clear - they don't
stop fractures occurring. It always struck me as slightly bizarre for little old ladies to be
shuffling about in hot, heavy bloomers full of cotton wool anyway.
Best wishes,
Rowley Cottingham
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http://www.emergencyunit.com
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