Risk of hip fractures in soft protected, hard protected, and unprotected falls.

OBJECTIVE To compare hip fracture risk in soft and hard protected falls with the risk in unprotected falls and to compare the incidence of hip fractures in nursing homes providing soft and hard hip protectors. METHODS An observational study conducted within the framework of a cluster randomized trial in 18 nursing homes. Nursing homes were randomized to offer either soft or hard hip protectors. Individual participants were followed for falls for 18 months. RESULTS Of 1236 participating residents, 607 suffered 2926 falls; 590 of the 2926 falls were categorized as soft protected, 852 as hard protected, and 1388 as unprotected falls. Sixty-six verified hip fractures occurred: eight in soft protected falls, 11 in hard protected falls, and 45 in unprotected falls. The hip fracture risk in soft and hard protected falls was almost 60% lower than in unprotected falls (OR (soft) 0.36, 95% CI 0.17 to 0.77; OR (hard) 0.41, 95% CI 0.19 to 0.89). The incidence of hip fracture was 4.6 and 6.2 per 100 person-years in nursing homes providing soft and hard hip protectors, respectively (p = 0.212). CONCLUSION Both types of hip protector have the potential, when worn correctly, to reduce the risk of a hip fracture in falls by nearly 60%. Both can be recommended to nursing-home residents as a means of preventing hip fractures.