Hip protector

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Hip protector

Hip protectors are special trousers with protective elements sewn into them to protect the wearer from hip or femoral neck fractures and to prevent them. In addition to this protection, however, problems such as a lack of acceptance or an increase in functional urinary or fecal incontinence can arise. The costs for this preventive measure are not covered by health insurance companies in Germany .

Mode of action

Hip or thigh fractures are usually caused by a lateral fall on the thigh bone , especially the neck, or the pelvis . To prevent this, hip protectors consist of specially developed underwear in which pockets are incorporated in the hip area. These bags contain plate-like protective elements that are available in both hard and soft versions. Basically, one differentiates between hip protectors of the "helmet type" and "energy-absorbing type". The "crash helmet type" diverts the force that would otherwise lead to a fracture into the surrounding tissue, the "energy-absorbing type" absorbs this and reduces it. Both systems can thus soften the acting force in such a way that it does not lead to a fracture. According to new study data, hip fractures are apparently more common than previously assumed: an estimated 141 per 100,000 population suffer a hip fracture in Germany every year. These fractures can therefore be described as a frequent occurrence. Icks u. a. analyzed all discharge cases nationwide with a hip fracture diagnosis in 2004 based on hospital diagnosis statistics. 116 281 patients with at least one hospital stay per year due to hip fracture were calculated. That corresponds to an incidence of 141 per 100,000 inhabitants. So far the incidence has been estimated at 122 per 100,000 inhabitants based on data from a large national health insurance company. Apart from vertebral fractures, hip fractures are a particularly feared complication in osteoporosis patients . An estimated 30 percent of those affected die within a year, and every third person with a hip fracture becomes permanently disabled.

Acceptance, use, errors of use

A large number of hip protectors with different mechanisms of action are commercially available. The effect of hip protectors has been confirmed in various studies, but the acceptance and proper use ( compliance ) is often too low. Newly designed and developed hip protectors may eliminate or prevent such problems.

Two problems lead to the rejection of the protectors: Difficulties in dressing and undressing and the local heating caused by another layer of underwear that is not breathable. The protectors incorporated in plastic should not slip. Therefore the carrier material is very tight and has to fit tightly. This leads to normal heat and sweating, which many find uncomfortable. A remedy in this case are protectors that are glued directly to the skin of the thigh with an adhesive surface.

Putting on and taking off protective pants when going to the toilet can be difficult for weak or mentally impaired people. On the one hand, this leads to an apparent urinary or fecal incontinence because the toilet is not reached in time. On the other hand, the trousers are not worn or used improperly in order to avoid this functional incontinence. Then they are ineffective. If caregivers are present, it can be recommended to go to the toilet early and regularly under the guidance or assistance of the carer in order to avoid such "mishaps".

In Germany, hip protectors cannot be prescribed as an aid to the detriment of statutory health insurance (GKV). The National Association of Statutory Health Insurance Funds refused to be included in the list of medical aids, which led to a legal dispute with a sales company for hip protectors. On April 22, 2009, the 3rd Senate of the Federal Social Court (BSG) rejected the action directed against this under the file number B 3 KR 11/07 R. To justify the judgment, it was stated that hip protectors are not included in the list of medical aids because they neither prevent an impending disability nor serve to ensure the success of the treatment. According to the BSG, hip protectors are used purely as a prophylaxis for the consequences of falls - these are the responsibility of those affected. The BSG left the option open as to whether the hip protectors could be included in the list of nursing aids. A prerequisite for this would be that the protectors enable the person concerned to lead a more independent life or serve to facilitate care. A decision on inclusion in the list of nursing aids has not yet been made.

literature

  • German network for quality development in nursing : Expert standard for fall prevention in nursing. including commentary and literature analysis. 2005, ISBN 3-00-015082-X .
  • P. Kannus, J. Parkkari, S. Niemi, M. Pasanen, M. Palvanen, M. Jarvinen, I. Vuori: Prevention of hip fracture in elderly people with use of a hip protector. In: N Engl J Med. 343, 2000, pp. 1506–1513 (engl.)
  • MJ Parker, WJ Gillespie, LD Gillespie: Hip protectors for preventing hip fractures in older people. In: Cochrane Database Syst Rev. 3, 2005, p. CD001255. (engl.)
  • LA Holzer, G. Holzer: The importance of hip protectors for the prevention of hip fractures in older people. In: Wien Med Wochenschr. 157, 2007, pp. 381-387.
  • Adriano Pierobon, Manfred Funk: Fall prevention in the elderly. + DVD. Georg Thieme Verlag, 2007, ISBN 978-3-13-143761-7 .

Web links

Individual evidence

  1. ↑ DMW 133, 2008, 125
  2. ↑ Quoted from the Ärzte Zeitung . July 16, 2008.
  3. ↑ Health insurers do not have to pay for hip protectors. In: Doctors newspaper , April 24, 2009; Retrieved May 12, 2009.