[EBM of hip protectors].

In Japan, where the population is rapidly growing older, the prevention of hip fractures is becoming increasingly important. Although bisphosphonates were reported to prevent these fractures, their effectiveness was confirmed in relatively younger elderly patients. The prevention of hip fractures, the majority of which occur in older people, may not be achieved sufficiently only by bisphosphonates, and may require other measures including the use of a hip protector. Elderly people who tend to fall, nursing-home residents, and elderly patients who have already suffered from a hip fracture are considered to be good candidates for wearing hip protectors. The main mechanism of hip fractures is falling sideways over the trochanter. Hip protectors have been developed to attenuate the impact force on the trochanter that results from falling. There have been 6 randomized clinical trials and 4 of them confirmed the efficacy of hip protectors in preventing hip fractures. The other 2 reports did not show a statistically significant efficacy, but a large number of falls occurred without wearing hip protectors. The problem of the limited adherence with their use should be solved.