Protectors may not prevent fractures, I agree, largely as the pelvis still
undergoes a very rapid deceleration when it hits the floor, which is only
minimally offset by the presence of the worn protector. However, that does
not support your assertion that around 50% of fractures actually occur
before the patient even begins to fall! I don't believe this for a moment,
Rowley, and all of my patients clearly give a history of a simple mechanical
"trip" which then results in a heavy collision with the ground which
produces the fracture. I wonder who your memorable teacher was, and does
anyone else hold this viewpoint?
Adrian
----- Original Message -----
From: "Rowley Cottingham" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, August 15, 2003 6:11 AM
Subject: Hip protectors are ineffective
> 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
>
> [log in to unmask]
> http://www.emergencyunit.com
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