• 南方醫(yī)科大學(xué)解剖教研室 廣東省醫(yī)學(xué)生物力學(xué)重點實驗室（廣州，510515）;

【摘 要】 目的 總結(jié)髖關(guān)節(jié)保護(hù)器（hip protector，HP）的應(yīng)用及研究現(xiàn)況，探討目前存在的問題及進(jìn)一步研究方向。 方法 查閱國內(nèi)外近年關(guān)于HP的文獻(xiàn)，進(jìn)行分析總結(jié)。 結(jié)果 目前生物力學(xué)試驗研究顯示HP具有良好的防護(hù)摔倒所致髖關(guān)節(jié)骨折的效果，而在臨床應(yīng)用中未顯示有確切的相關(guān)防護(hù)效果。 結(jié)論 HP生物力學(xué)試驗中防護(hù)效果較好可能與其采用較低沖擊能量有關(guān)；臨床應(yīng)用中HP依從性差被認(rèn)為是導(dǎo)致其防護(hù)效果差的最主要原因。

引用本文： 孫培棟,歐陽鈞. 髖關(guān)節(jié)保護(hù)器的研究現(xiàn)況及展望. 中國修復(fù)重建外科雜志, 2012, 26(1): 41-45. doi: 復(fù)制

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1. Soc, 2004, 52(5): 685-690.
2. controlled trial. JAMA, 2007, 298(4): 413-422.
3. use of hip protectors in nursing homes: cluster randomised controlled trial. BMJ, 2003, 326(7380): 76.
4. people with use of a hip protector. N Engl J Med, 2000, 343(21): 1506-1513.
5. a cluster randomized trial. J Am Med Dir Assoc, 2011, 12(1): 50-57.
6. simulated falls. Clin Biomech (Bristol, Avon), 2010, 25(1): 63-69.
7. designed hip protector for older chinese women. Geriatr Nurs, 2008, 29(1): 64-69.
8. J Biomech Eng, 2008, 130(6): 061005.
9. distribution to the hip during sideways falls. Osteoporos Int, 2008, 19(7): 1067-1075.
10. hip protector in young volunteers. Calcif Tissue Int, 1997, 60(4): 354-357.
11. fracture threshold: an in vitro biomechanical study under falling conditions of the elderly. J Bone Miner Res, 1995, 10(10): 1437-1442.
12. for biomechanical testing—an international consensus statement.
13. (part I). Osteoporos Int, 2009, 20(12): 1977-1988.
14. study. Int J Nurs Stud, 2011, 48(2): 193-203.
15. Int, 2011, 22(2): 617-626.
16. for hip fracture prevention and compliance with use in elderly Hong Kong Chinese. Clin Rehabil, 2003, 17(2): 203-205.
17. Keene GS, Parker MJ, Pryor GA. Mortality and morbidity after hip fractures. BMJ, 1993, 307(6914): 1248-1250.
18. Empana JP, Dargent-Molina P, Bréart G. Effect of hip fracture on mortality in elderly women: the EPIDOS prospective study. J Am Geriatr.
19. Grisso JA, Kelsey JL, Strom BL, et al. Risk-factors for falls as a cause of hip fracture in women. Northeast Hip Fracture Study Group. New Engl J Med, 1991, 324(19): 1326-1331.
20. Lauritzen JB, Petersen MM, Lund B. Effect of external hip protectors on hip fractures. Lancet, 1993, 341(8836): 11-13.
21. Koike T, Orito Y, Toyoda H, et al. External hip protectors are effective for the elderly with higher-than-average risk factors for hip fractures. Osteoporosis Int, 2009, 20(9): 1613-1620.
22. Kiel DP, Magaziner J, Zimmerman S, et al. Efficacy of a hip protector to prevent hip fracture in nursing home residents: the HIP PRO randomized.
23. O’Halloran PD, Cran GW, Beringer TR, et al. A cluster randomised controlled trial to evaluate a policy of making hip protectors available to residents of nursing homes. Age Ageing, 2004, 33(6): 582-588.
24. Birks YF, Porthouse J, Addie C, et al. Randomized controlled trial of hip protectors among women living in the community. Osteoporosis Int, 2004, 15(9): 701-706.
25. van Schoor NM, Smit JH, Twisk JW, et al. Prevention of hip fractures by external hip protectors: a randomized controlled trial. JAMA, 2003, 289(15): 1957-1962.
26. Meyer G, Warnke A, Bender R, et al. Effect on hip fractures of increased.
27. Birks YF, Hildreth R, Campbell P, et al. Randomised controlled trial of hip protectors for the prevention of second hip fractures. Age Ageing, 2003, 32(4): 442-444.
28. Harada A, Mizuno M, Takemura M, et al. Hip fracture prevention trial using hip protectors in Japanese nursing homes. Osteoporos Int, 2001, 12(3): 215-221.
29. Cameron ID, Cumming RG, Kurrle SE. Prevention of hip fracture with use of a hip protector. New Engl J Med, 2001, 344(11): 855-856.
30. Kannus P, Parkkari J, Niemi S, et al. Prevention of hip fracture in elderly.
31. Chan DK, Hillier G, Coore M, et al. Effectiveness and acceptability of a newly designed hip protector: a pilot study. Arch Gerontol Geriatr, 2000, 30(1): 25-34.
32. Cameron ID, Kurrle SE, Quine S, et al. Improving adherence with the use of hip protectors among older people living in nursing care facilities:.
33. Gillespie WJ, Gillespie LD, Parker MJ. Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev, 2010, (10): CD001255.
34. Sawka AM, Boulos P, Beattie K, et al. Do hip protectors decrease the risk of hip fracture in institutional and community-dwelling elderly? A systematic review and meta-analysis of randomized controlled trials. Osteoporosis Int, 2005, 16(12): 1461-1474.
35. Gillespie WJ, Gillespie LD, Parker MJ. Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev, 2010, (10): CD001255.
36. Parker MJ, Gillespie LD, Gillespie WJ. Hip protectors for preventing hip fractures in the elderly. Cochrane Database Syst Rev, 2001, (2): CD001255.
37. Choi WJ, Hoffer JA, Robinovitch SN. The effect of positioning on the biomechanical performance of soft shell hip protectors. J Biomech, 2010, 43(5): 818-825.
38. Choi WJ, Hoffer JA, Robinovitch SN. Effect of hip protectors, falling angle and body mass index on pressure distribution over the hip during.
39. Sze PC, Cheung WH, Qin L, et al. Biomechanical study of an anthropometrically.
40. Laing AC, Robinovitch SN. The force attenuation provided by hip protectors depends on impact velocity, pelvic size, and soft tissue stiffness.
41. Laing AC, Robinovitch SN. Effect of soft shell hip protectors on pressure.
42. Nabhani F, Bamford J. Mechanical testing of hip protectors. J Mater Process Tech, 2002, 124(3): 311-318.
43. Kannus P, Parkkari J, Poutala J. Comparison of force attenuation properties of four different hip protectors under simulated falling conditions in the elderly: an in vitro biomechanical study. Bone, 1999, 25(2): 229-235.
44. Parkkari J, Kannus P, Heikkilä J, et al. Impact experiments of an external.
45. Robinovitch SN, Hayes WC, McMahon TA. Energy-shunting hip padding system attenuates femoral impact force in a simulated fall. J Biomech Eng, 1995, 117(4): 409-413.
46. Parkkari J, Kannus P, Heikkilä J, et al. Energy-shunting external hip protector attenuates the peak femoral impact force below the theoretical.
47. Parkkari J, Kannus P, Poutala J, et al. Force attenuation properties of various trochanteric padding materials under typical falling conditions of the elderly. J Bone Miner Res, 1994, 9(9): 1391-1396.
48. Derler S, Spierings AB, Schmitt KU. Anatomical hip model for the mechanical testing of hip protectors. Med Eng Phys, 2005, 27(6): 475-485.
49. Robinovitch SN, Evans SL, Minns J, et al. Hip protectors: recommendations.
50. Sawka AM, Nixon M, Giangregorio L, et al. The use of hip protectors in long-term care facilities: a survey of nursing home staff. J Am Med Dir Assoc, 2007, 8(4): 229-232.
51. Milisen K, Coussement J, Boonen S, et al. Nursing staff attitudes of hip protector use in long-term care, and differences in characteristics between adherent and non-adherent residents: a survey and observational.
52. Cameron ID, Kurrle S, Quine S, et al. Increasing adherence with the use of hip protectors for older people living in the community. Osteoporos.
53. Parker MJ, Gillespie LD, Gillespie WJ. Hip protectors for preventing hip fractures in the elderly. Cochrane Database Syst Rev, 2001, (2): CD001255.
54. 王鳳英, 杜春萍, 何成奇. 髖保護(hù)器的臨床應(yīng)用. 中國組織工程研究與臨床康復(fù), 2007, 11(18): 3637-3639.
55. 王書軍, 王麗霞, 李桂蘭. 老年人髖部骨折的機制及其防護(hù)墊的設(shè)計. 中醫(yī)正骨, 2008, 20(9): 22.
56. Woo J, Sum C, Yiu HH, et al. Efficacy of a specially designed hip protector.
  1. 1. Soc, 2004, 52(5): 685-690.
  2. 2. controlled trial. JAMA, 2007, 298(4): 413-422.
  3. 3. use of hip protectors in nursing homes: cluster randomised controlled trial. BMJ, 2003, 326(7380): 76.
  4. 4. people with use of a hip protector. N Engl J Med, 2000, 343(21): 1506-1513.
  5. 5. a cluster randomized trial. J Am Med Dir Assoc, 2011, 12(1): 50-57.
  6. 6. simulated falls. Clin Biomech (Bristol, Avon), 2010, 25(1): 63-69.
  7. 7. designed hip protector for older chinese women. Geriatr Nurs, 2008, 29(1): 64-69.
  8. 8. J Biomech Eng, 2008, 130(6): 061005.
  9. 9. distribution to the hip during sideways falls. Osteoporos Int, 2008, 19(7): 1067-1075.
  10. 10. hip protector in young volunteers. Calcif Tissue Int, 1997, 60(4): 354-357.
  11. 11. fracture threshold: an in vitro biomechanical study under falling conditions of the elderly. J Bone Miner Res, 1995, 10(10): 1437-1442.
  12. 12. for biomechanical testing—an international consensus statement.
  13. 13. (part I). Osteoporos Int, 2009, 20(12): 1977-1988.
  14. 14. study. Int J Nurs Stud, 2011, 48(2): 193-203.
  15. 15. Int, 2011, 22(2): 617-626.
  16. 16. for hip fracture prevention and compliance with use in elderly Hong Kong Chinese. Clin Rehabil, 2003, 17(2): 203-205.
  17. 17. Keene GS, Parker MJ, Pryor GA. Mortality and morbidity after hip fractures. BMJ, 1993, 307(6914): 1248-1250.
  18. 18. Empana JP, Dargent-Molina P, Bréart G. Effect of hip fracture on mortality in elderly women: the EPIDOS prospective study. J Am Geriatr.
  19. 19. Grisso JA, Kelsey JL, Strom BL, et al. Risk-factors for falls as a cause of hip fracture in women. Northeast Hip Fracture Study Group. New Engl J Med, 1991, 324(19): 1326-1331.
  20. 20. Lauritzen JB, Petersen MM, Lund B. Effect of external hip protectors on hip fractures. Lancet, 1993, 341(8836): 11-13.
  21. 21. Koike T, Orito Y, Toyoda H, et al. External hip protectors are effective for the elderly with higher-than-average risk factors for hip fractures. Osteoporosis Int, 2009, 20(9): 1613-1620.
  22. 22. Kiel DP, Magaziner J, Zimmerman S, et al. Efficacy of a hip protector to prevent hip fracture in nursing home residents: the HIP PRO randomized.
  23. 23. O’Halloran PD, Cran GW, Beringer TR, et al. A cluster randomised controlled trial to evaluate a policy of making hip protectors available to residents of nursing homes. Age Ageing, 2004, 33(6): 582-588.
  24. 24. Birks YF, Porthouse J, Addie C, et al. Randomized controlled trial of hip protectors among women living in the community. Osteoporosis Int, 2004, 15(9): 701-706.
  25. 25. van Schoor NM, Smit JH, Twisk JW, et al. Prevention of hip fractures by external hip protectors: a randomized controlled trial. JAMA, 2003, 289(15): 1957-1962.
  26. 26. Meyer G, Warnke A, Bender R, et al. Effect on hip fractures of increased.
  27. 27. Birks YF, Hildreth R, Campbell P, et al. Randomised controlled trial of hip protectors for the prevention of second hip fractures. Age Ageing, 2003, 32(4): 442-444.
  28. 28. Harada A, Mizuno M, Takemura M, et al. Hip fracture prevention trial using hip protectors in Japanese nursing homes. Osteoporos Int, 2001, 12(3): 215-221.
  29. 29. Cameron ID, Cumming RG, Kurrle SE. Prevention of hip fracture with use of a hip protector. New Engl J Med, 2001, 344(11): 855-856.
  30. 30. Kannus P, Parkkari J, Niemi S, et al. Prevention of hip fracture in elderly.
  31. 31. Chan DK, Hillier G, Coore M, et al. Effectiveness and acceptability of a newly designed hip protector: a pilot study. Arch Gerontol Geriatr, 2000, 30(1): 25-34.
  32. 32. Cameron ID, Kurrle SE, Quine S, et al. Improving adherence with the use of hip protectors among older people living in nursing care facilities:.
  33. 33. Gillespie WJ, Gillespie LD, Parker MJ. Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev, 2010, (10): CD001255.
  34. 34. Sawka AM, Boulos P, Beattie K, et al. Do hip protectors decrease the risk of hip fracture in institutional and community-dwelling elderly? A systematic review and meta-analysis of randomized controlled trials. Osteoporosis Int, 2005, 16(12): 1461-1474.
  35. 35. Gillespie WJ, Gillespie LD, Parker MJ. Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev, 2010, (10): CD001255.
  36. 36. Parker MJ, Gillespie LD, Gillespie WJ. Hip protectors for preventing hip fractures in the elderly. Cochrane Database Syst Rev, 2001, (2): CD001255.
  37. 37. Choi WJ, Hoffer JA, Robinovitch SN. The effect of positioning on the biomechanical performance of soft shell hip protectors. J Biomech, 2010, 43(5): 818-825.
  38. 38. Choi WJ, Hoffer JA, Robinovitch SN. Effect of hip protectors, falling angle and body mass index on pressure distribution over the hip during.
  39. 39. Sze PC, Cheung WH, Qin L, et al. Biomechanical study of an anthropometrically.
  40. 40. Laing AC, Robinovitch SN. The force attenuation provided by hip protectors depends on impact velocity, pelvic size, and soft tissue stiffness.
  41. 41. Laing AC, Robinovitch SN. Effect of soft shell hip protectors on pressure.
  42. 42. Nabhani F, Bamford J. Mechanical testing of hip protectors. J Mater Process Tech, 2002, 124(3): 311-318.
  43. 43. Kannus P, Parkkari J, Poutala J. Comparison of force attenuation properties of four different hip protectors under simulated falling conditions in the elderly: an in vitro biomechanical study. Bone, 1999, 25(2): 229-235.
  44. 44. Parkkari J, Kannus P, Heikkilä J, et al. Impact experiments of an external.
  45. 45. Robinovitch SN, Hayes WC, McMahon TA. Energy-shunting hip padding system attenuates femoral impact force in a simulated fall. J Biomech Eng, 1995, 117(4): 409-413.
  46. 46. Parkkari J, Kannus P, Heikkilä J, et al. Energy-shunting external hip protector attenuates the peak femoral impact force below the theoretical.
  47. 47. Parkkari J, Kannus P, Poutala J, et al. Force attenuation properties of various trochanteric padding materials under typical falling conditions of the elderly. J Bone Miner Res, 1994, 9(9): 1391-1396.
  48. 48. Derler S, Spierings AB, Schmitt KU. Anatomical hip model for the mechanical testing of hip protectors. Med Eng Phys, 2005, 27(6): 475-485.
  49. 49. Robinovitch SN, Evans SL, Minns J, et al. Hip protectors: recommendations.
  50. 50. Sawka AM, Nixon M, Giangregorio L, et al. The use of hip protectors in long-term care facilities: a survey of nursing home staff. J Am Med Dir Assoc, 2007, 8(4): 229-232.
  51. 51. Milisen K, Coussement J, Boonen S, et al. Nursing staff attitudes of hip protector use in long-term care, and differences in characteristics between adherent and non-adherent residents: a survey and observational.
  52. 52. Cameron ID, Kurrle S, Quine S, et al. Increasing adherence with the use of hip protectors for older people living in the community. Osteoporos.
  53. 53. Parker MJ, Gillespie LD, Gillespie WJ. Hip protectors for preventing hip fractures in the elderly. Cochrane Database Syst Rev, 2001, (2): CD001255.
  54. 54. 王鳳英, 杜春萍, 何成奇. 髖保護(hù)器的臨床應(yīng)用. 中國組織工程研究與臨床康復(fù), 2007, 11(18): 3637-3639.
  55. 55. 王書軍, 王麗霞, 李桂蘭. 老年人髖部骨折的機制及其防護(hù)墊的設(shè)計. 中醫(yī)正骨, 2008, 20(9): 22.
  56. 56. Woo J, Sum C, Yiu HH, et al. Efficacy of a specially designed hip protector.