Hip Pads Research Articles

A Novel Hip Pad Design to Prevent Meralgia Paresthetica After Surgery in the Prone Position

A Novel Hip Pad Design to Prevent Meralgia Paresthetica After Surgery in the Prone Position

The Yoga Mat Technique in Postless Hip Arthroscopy

Hip arthroscopy for the treatment of femoroacetabular impingement syndrome with anti-sliding techniques and without the use of a perineal post to achieve hip distraction has increased greatly in the past 5 to 10 years. To access the hip joint, distraction is mandatory to treat intra-articular disorders such as labral tears, acetabular cartilage defects, loose bodies, ligamentum teres tears, and avascular necrosis of the hip. In hip distraction, counter-distraction is needed, and this is achieved with a bulky and cushioned perineal post. Most of the described techniques in hip arthroscopy worldwide use a perineal post, but iatrogenic pudendal nerve, genital lacerations, hematomas, and groin complications have been reported to occur. In Latin American countries, disposable hip pad devices are expensive, and not all the arthroscopic companies provide them. Our yoga mat technique provides enough countertraction to achieve adequate hip distraction. Labral repair, labral reconstruction, and decompression of femoroacetabular impingement syndrome have been achieved properly, reliably, and reproducibly, and no Trendelenburg position is needed. Postless hip arthroscopy is made simple, and positioning the patient is not difficult. Hip surgeons can adapt this technique to a fracture table, a hip distractor, and a standard operating room table.

Rehabilitation therapy for patients with osteoporosis

Fractures in patients with osteoporosis are attributable to falls and reduced bone mass. Therefore, balance and muscle strength should be improved and bone mass should be increased to prevent fractures. This study aims to investigate a rehabilitation treatment for osteoporosis. Exercise is a potentially safe and effective way to increase bone density and prevent postmenopausal bone loss. Based on bone densitometry results, rehabilitation exercises can be applied variably. Fractures caused by osteoporotic fragility may be prevented with multidisciplinary intervention programs including education, environmental modifications, aids, and individually tailored exercise programs. In addition, strengthening the paraspinal muscles may not only maintain bone mineral density but also reduce the risk of vertebral fractures. Rehabilitation after vertebral fractures includes proprioceptive dynamic posture training that decreases kyphotic posturing through the recruitment of back extensors. This training reduces pain, improves mobility, and leads to a better quality of life. Hip fractures may be prevented by hip protectors and exercise programs that can improve the strength and mobility of patients with hip fractures. Considering the musculoskeletal condition, the spine should be protected using a spinal orthosis, taping, hip pad, and walking aid, if necessary. Efforts to activate programs such as fracture liaison services should also be considered.

Effect of Impact Velocity, Flooring Material, and Trochanteric Soft-Tissue Quality on Acetabular Fracture during a Sideways Fall: A Parametric Finite Element Approach

A low-energy acetabular fracture, as a result of falling from standing height, is common among elderly patients and the number of cases is increasing rapidly in developed countries. Several biomechanical factors contribute to the incidence, severity, and type of acetabular fractures, such as body configuration at the impact moment or bone and soft-tissue quality. The current parametric study developed a comprehensive finite element model of the pelvic girdle and simple representation of the whole body and investigated the effects of impact velocity, conventional indoor/outdoor flooring material, and trochanteric soft-tissue stiffness on an acetabular fracture. Our results show that whereas the impact velocity has a substantial influence on the incidence and type of acetabular fracture, the effects of conventional flooring materials and trochanteric soft-tissue quality are not remarkable. It seems that other factors such as the quality of bone (healthy vs. osteoporotic), the thickness of trochanteric soft-tissue, and body configuration at the impact are more critical in the occurrence and type of the acetabular fracture. These results can be valuable in the prevention of acetabular fractures and the design of protective measures such as hip pads or novel flooring materials.

Force attenuation properties of shear-thickening polymer (STP)-based hip protector in simulated sideways fall

Shear-thickening polymer (STP) has a unique property of increasing its viscosity with an increase in shear strain to attenuate the application of force, implying that it can be used as a material for hip protectors. This study introduces a new hip protector composed of STP and compares its force attenuation capacity to that of other commercial hip protectors in simulated sideways falls. The performance of the STP-based hip protector was analyzed against eight commercial hip protectors (Pelican, Posey, SafeHip, Hornsby, FallSafe, HipSaver, Impact Wear (Hard), Impact Wear (Soft)). The simulated sideways fall conditions were created by a drop weight impact testing system using an anatomical hip model. The machine was dropped from a 20 or 30 cm height resulting in impact energy of 25.1 J (low) or 44.1 J (moderate), respectively. At low impact energy, the commercial hip protectors showed an attenuation range from 21.6 % to 53.3 %, and the STP-based hip pad was able to attenuate the force by 42.7 %. At moderate impact energy, the commercial hip protectors showed an attenuation range from 23 % to 54.3 %, and the STP-based hip pad was able to attenuate the force by 32.6 %. The low coefficient of variance showed a high precision in the execution of the experiments. Although the STP-based hip protector was thinner than the average of commercial soft shell pads and retained comfortable fit, it showed comparable force attenuation capacity to the commercial ones for the low impact energy test. This study highlights that STP, in combination with a polyurethane foam layer, provides the best features in energy-absorption and shunting, showing that it can be used in hip protectors to gain a competitive advantage over others.

Absorptive protective padding with electrospinned polyester fibers with hydrogel matrix

Hip fractures has been prevalent especially among aged elderly. This can lead to permanent disability of the elderly as they are wheel-chaired bound after suffering from hip fractures. In this work, we explore the design of a protective hip pad which encapsulate the hydrogel and fibres composite in a laminated sheet. The hydrogel was fabricated using Polyvinyl alcohol (PVA) with distilled water. Two types of electrospinned fibres, Nylon-6 fibres and polyester fibres were used as filler. The fabrication of hydrogel matrix composite was varied by the weight percent of nylon 6,6 pellets dissolving in formic acid as compared to Hydrolysed Poly(Vinyl alcohol) to form crosslinked PVA with water. The impact absorption concept was to allow the gel-like hydrogel to flow through the fibres pores and during this process, part of the energy would be dissipated in the matrix composite. This lower the impact force being transferred to the user’s hip and prevent the facture of the elderly’s hips during fall. The protective padding with 20 layers of polyester fibres with 2.5wt % of PVA had the lowest impact force of 0.8 kN as compared to conventional protective padding with measured 1.07kN impact force for impact study.

Presencia de puntos gatillo miofasciales en pacientes con ictus isquémico agudo: estudio piloto descriptivo transversal

ObjectivesTo determine the presence of active and latent MTrPs in 4 shoulder muscles and 4 hip muscles of the paretic and non-paretic limbs, in patients with acute ischaemic stroke, and to analyse if there is a relationship with the degree of strength of the paretic extremities. Patients and methods22 patients with ischaemic stroke of less than 5 days’ evolution were selected, admitted to the Stroke Unit of a hospital centre with mild or moderate neurological severity (National Institute of Health Stroke Scale 3-15), brachial and / or leg paresis, and that prior to admission presented functional autonomy or mild or very mild disability (modified Rankin scale 0-2). The MTrPs were recorded in 4 muscles of easy palpable access of each shoulder and 4 of each hip, following the diagnostic criteria of Simons, Travell & Simons. ResultsAll the patients showed latent MTrPs in the shoulder and hip pads, being more frequent in the infraspinatus (94.4%) and in the gluteus maximus (78.9%). The degree of strength of the paretic limbs correlated with the presence of latent PGMs in specific areas of both muscles. ConclusionsThe results point towards a high presence of MTrPs, predominantly latent, in the shoulder and hip of the paretic limbs secondary to acute ischaemic stroke. In turn, they suggest a possible correlation between the presence of latent MTrPs and the degree of strength of the same paretic limbs. However, studies of larger sample size are needed to corroborate what was found in this pilot study.

한국 노인의 3D 인체특성 분석을 통한 Hip protector 치수체계 수립 및 입체패턴 설계

This study aimed to develop an optimal sizing system and a draping pattern for hip protector based on an analysis of anthropometric characteristics of Korean older women. A hip protector is a specialized form of pants or underwear containing pads along the outside of each hip. The 3D body scan data of Korean older women were analyzed to identify their anthropometric characteristics and a four-size system with 93% of population accommodation was developed by clustering analysis based on key dimensions derived from factor analysis. The sizing system consists of small/short, large/short, small/tall, and large/tall. A 3D physical model and hip pads were fabricated; then, a hip protector was draped on the 3D model and hip pads. The sizing system of hip protector was analyzed in terms of size and shape and a draping pattern was compared on back center, back side, front side, front center and pad. Lastly, the pattern deformation and clothing pressure were analyzed using the virtual clothing system CLO. Virtual system have disadvantage of not to suggest the objective value. In the future research the wearing comfort and impact absorption of the hip protector needs to be tested and then a hip protector design will be finalized by considering the hip protector's size, material, comfort testing results, aesthetic appeal, protection effectiveness, and practical utility of everyday use.

Hip protectors for preventing hip fractures in older people.

Older people living in nursing care facilities or older adults living at home are at high risk of falling and a hip fracture may occur after a fall. Hip protectors have been advocated as a means to reduce the risk of hip fracture. Hip protectors are plastic shields (hard) or foam pads (soft), usually fitted in pockets in specially designed underwear.This is an update of a Cochrane review first published in 1999, and updated several times, most recently in 2010. To determine if the provision of external hip protectors (sometimes referred to as hip pads or hip protector pads) reduces the risk of fracturing the hip in older people. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (December 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 12), MEDLINE (1950 to week 3 November 2012), MEDLINE In-Process (18 December 2012), EMBASE (1988 to 2012 Week 50), CINAHL (1982 to December 2012), BioMed Central (January 2010), trial registers and reference lists of relevant articles. All randomised or quasi-randomised controlled trials comparing an intervention group provided with hip protectors with a control group not provided with hip protectors. Two review authors independently assessed risk of bias and extracted data. We sought additional information from trialists. Data were pooled using fixed-effect or random-effects models as appropriate. This review includes 19 studies, nine of which were cluster randomised. These included approximately 17,000 people (mean age range 78 to 86 years). Most studies were overall at low risk of bias for fracture outcomes. Trials tested hard or soft hip protectors enclosed in special underwear in 18 studies.Pooling of data from 14 studies (11,808 participants) conducted in nursing or residential care settings found moderate quality evidence for a small reduction in hip fracture risk (risk ratio (RR) 0.82, 95% confidence interval (CI) 0.67 to 1.00); the absolute effect is 11 fewer people (95% CI, from 20 fewer to 0) per 1000 having a hip fracture when provided with hip protectors.There is moderate quality evidence when pooling data from five trials in the community (5614 participants) that shows little or no effect in hip fracture risk (RR 1.15, 95% CI 0.84 to 1.58); the absolute effect is two more people (95% CI 2 fewer to 6 more) per 1000 people having a hip fracture when provided with hip protectors.There is probably little to no effect on falls (rate ratio 1.02, 95% CI 0.9 to 1.16) or fractures other than of the hip or pelvis (rate ratio 0.87, 95% CI 0.71 to 1.07). However, the risk ratio for pelvic fractures is RR 1.27 (95% CI 0.78 to 2.08); this is an absolute effect of one more person (95% CI 1 fewer to 5 more) per 1000 having a pelvic fracture when provided with hip protectors.The incidence of adverse events while wearing hip protectors, including skin irritation, ranged from 0% to 5%. Adherence, particularly in the long term, was poor. Hip protectors probably reduce the risk of hip fractures if made available to older people in nursing care or residential care settings, without increasing the frequency of falls. However, hip protectors may slightly increase the small risk of pelvic fractures. Poor acceptance and adherence by older people offered hip protectors is a barrier to their use. Better understanding is needed of the personal and design factors that may influence acceptance and adherence.

Intervention and Documentation Reduce Exposure From Falls

Intervention and Documentation Reduce Exposure From Falls

Simple and safe head positioning device for repair of craniosynostosis with the patient prone

m a roper positioning of the head is key in the operative corection of craniosynostosis. If the patient is prone it provides n overview of the skull and allows access from the supraorital margin to the external occipital protuberance. Because f the generous view provided by this position, the placeent and shaping of the bony fragments can be ideal, which eads to excellent aesthetic results. However, only a few of he available positioning devices are acceptable. In this paper we describe a simple and economical ethacrylate holder covered with a gel mat (Action Fracure Table Hip Pad; Allenspach Medical AG, Balsthal, witzerland) taped onto the operating table to place young atients prone for the surgical correction of craniosynostosis. The diagnosis, management, and treatment of craniosynstosis can be complex, and an interdisciplinary approach is ssential.1 Powiertowski et al.2 first described subtotal cranoplasty, and several more extensive procedures have been escribed subsequently.3,4 Surgical treatment can be achieved safely by keeping the atient prone.5 The use of a vacuum-stiffened beanbag was escribed for this in 1989,5 but since then, no new, more perorated device has been described. In this paper we describe he use of a methacrylate holder to allow safe and simple xation of the skull during repair of craniosynostosis. A dental technician constructed the positioning device, hich is composed of polymerised methacrylate, after taking

2F06 大腿骨頸部骨折予防用ヒッププロテクタの衝撃緩和効果の評価(GS9:衝撃バイオメカニクス)

2F06 大腿骨頸部骨折予防用ヒッププロテクタの衝撃緩和効果の評価(GS9:衝撃バイオメカニクス)

B202 ヒッププロテクタ形状による大腿骨頸部骨折リスク制御メカニズム(B2-1 動態解析)

B202 ヒッププロテクタ形状による大腿骨頸部骨折リスク制御メカニズム(B2-1 動態解析)

Hip pads reduce the overall risk of injuries in recreational snowboarders

ObjectiveThe purpose is to determine common injuries in recreational snowboarding as targets of preventive strategy and protective gear that reduces the overall risk of these injuries.MethodsThe subjects comprised 5561 injured...

2404 歩行転倒シミュレーションによる高齢者転倒骨折防止ヒッププロテクタの生体力学的評価(OS24-1.計算バイオメカニクス(1),OS・一般セッション講演)

近年急速に増大している高齢者転倒による大腿骨頸部骨折に対しては,避けられなかった転倒における安全手段として有効なプロテクタが必要とされている.本研究では,高齢歩行者転倒を模擬したコンピュータシミュレーションを応用して,転倒骨折防止,もしくは危険性低減に有効なヒッププロテクタ形状の検討を行った.解析結果から,本研究で提案する新しい形状のヒッププロテクタの有効性を示すことが出来た.

Mechanical evaluation of hip pads to protect against fracture of elderly femurs in falls

Hip fracture in the aged easily occurs by falls and may cause these persons to become bedridden. Hip pads are effective in protecting hip fracture as they directly deflect and absorb the impact forces by falls. It is necessary for the material and the structure of hip pads to be designed to realize both high impact absorption and compliance (comfort during wearing). In this report, an impact testing system was developed to test the impact absorbing performance of hip pad with air cushions designed by the research group. The impact absorbing performance was evaluated by the impact load, collision time, and maximum load. To confirm the effectiveness in protecting against hip fracture, an impact force was applied to the greater trochanter of the human femur and the degree of fracture was measured by X-ray examination. As a result, the hip pad with air cushions had a high impact absorbing performance and was sufficiently effective to protect against hip fracture.

Is prophylactic fixation a cost-effective method to prevent a future contralateral fragility hip fracture?

: A previous hip fracture more than doubles the risk of a contralateral hip fracture. Pharmacologic and environmental interventions to prevent hip fracture have documented poor compliance. The purpose of this study was to examine the cost-effectiveness of prophylactic fixation of the uninjured hip to prevent contralateral hip fracture. : A Markov state-transition model was used to evaluate the cost and quality-adjusted life-years (QALYs) for unilateral fixation of hip fracture alone (including internal fixation or arthroplasty) compared with unilateral fixation and contralateral prophylactic hip fixation performed at the time of hip fracture or unilateral fixation and bilateral hip pad protection. Prophylactic fixation involved placement of a cephalomedullary nail in the uninjured hip and was initially assumed to have a relative risk of a contralateral fracture of 1%. Health states included good health, surgery-related complications requiring a second operation (infection, osteonecrosis, nonunion, and malunion), fracture of the uninjured hip, and death. The primary outcome measure was the incremental cost-effectiveness ratio estimated as cost per QALY gained in 2006 US dollars with incremental cost-effectiveness ratios below $50,000 per QALY gained considered cost-effective. Sensitivity analyses evaluated the impact of patient age, annual mortality and complication rates, intervention effectiveness, utilities, and costs on the value of prophylactic fixation. : In the baseline analysis, in a 79-year-old woman, prophylactic fixation was not found to be cost-effective (incremental cost-effectiveness ratio = $142,795/QALY). However, prophylactic fixation was found to be a cost-effective method to prevent contralateral hip fracture in: 1) women 71 to 75 years old who had 30% greater relative risk for a contralateral fracture; and 2) women younger than age 70 years. Cost-effectiveness was greater when the additional costs of prophylaxis were less than $6000. However, for most analyses, the success of prophylactic fixation was highly sensitive to the effectiveness and the relative morbidity and mortality of the additional procedure. : Prophylactic fixation with a cephalomedullary nail was not found to be cost-effective for the average older woman who sustained a hip fracture. However, it may be appropriate for select patient populations. The study supports the need for basic science and clinical trials investigating the effectiveness of prophylactic fixation for patient populations at higher lifetime risk for contralateral hip fracture.

J0201-3-1 大腿骨頸部骨折予防用ヒッププロテクタの形状・材料特性の生体力学的検討([J0201-3]自動車の衝突と傷害の力学(3))

The purpose of this project is to develop new hip pad for hip fracture which is frequently observed among Japanese elderly female. Hip fracture is one of the most important medical problems in Japanese geriatric medicine because it makes a patient difficult to stand and walk, In this study, we evaluated designs of hip pad to prevent hip fracture significantly. We discussed two types of foam materials and various shape of hip pad, and evaluated the effectiveness of those models using FE analysis. We got results that the size of the hole of hip pad has significant effects on fracture prevention.

The challenges of interpreting efficacy of hip protector pads in fracture prevention in high-risk seniors

Efficacy of hip protector pads to prevent hip fracture is controversial. This study was done to evaluate two comparable groups for fracture risk. Two matched cohorts of long-term care residents in Canada, assessing the efficacy of hip protector pads. Evaluation included demographics, medications/diagnoses, cognition (Mini Mental Status Examination (MMSE)), balance (Berg), bone mineral density (calcaneal ultrasound), falls/injuries at baseline and completion. Of the 58 participants, there were two confirmed hip fractures (8%) in the hip pad (one while wearing the pad) and eight (24%) in the control groups. But baseline demographics showed significant differences between hip pad (25) and control groups (33) in MMSE, Berg and osteoporosis treatment, all being less in the hip pad group. This persisted at completion, with a higher mortality in the hip pad group. Baseline differences predisposed the hip pad group to a higher fracture risk, but there were fewer hip fractures in this group. Small numbers, multifactorial nature of hip fractures and the inability to control for many of these variables in the real world make efficacy of hip protector pads difficult to confirm. Hip protector pads should be offered as part of the osteoporosis management of frail elderly, especially in those unable/unwilling to take pharmacotherapy.

Portable Preimpact Fall Detector With Inertial Sensors

Falls and the resulting hip fractures in the elderly are a major health and economic problem. The goal of this study was to investigate the feasibility of a portable preimpact fall detector in detecting impending falls before the body impacts on the ground. It was hypothesized that a single sensor with the appropriate kinematics measurements and detection algorithms, located near the body center of gravity, would be able to distinguish an in-progress and unrecoverable fall from nonfalling activities. The apparatus was tested in an array of daily nonfall activities of young (n=10) and elderly (n=14) subjects, and simulated fall activities of young subjects. A threshold detection method was used with the magnitude of inertial frame vertical velocity as the main variable to separate the nonfall and fall activities. The algorithm was able to detect all fall events at least 70 ms before the impact. With the threshold adapted to each individual subject, all falls were detected successfully, and no false alarms occurred. This portable preimpact fall detection apparatus will lead to the development of a new generation inflatable hip pad for preventing fall-related hip fractures.