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Hip

HAND DOMINANCE AND WALKING AID USE: PRE-DETERMINANTS FOR HIP FRACTURE?

British Hip Society (BHS) Meeting, Derby, England, March 2018



Abstract

Aim

Left sided hip fractures are more common but no obvious cause has been identified. Left handedness has previously been associated with an increased risk of fracture for a number of sites but to the best of our knowledge no association between handedness and hip fracture has previously been reported.

Methods

2 separate 6-month prospective reviews of hip fracture patients aged over 65 years-of-age were conducted at 2 different hospitals. Handedness was dete2rmined at the time of admission. The second review focused on the use of walking aids. Patients with a previous cerebrovascular accident, neurological condition or contralateral hip prosthesis were excluded due to increased balance problems and falls risk.

Results

Hand dominance was recorded for 339 patients; 304 right and 35 left. 91 patients were excluded. Of the remaining 248 patients more than twice as many (2.06 times) fractured their hip on the side of their non-dominant hand. For left handed individuals this increased to 4.6 times.

Walking aid use was recorded for 102 patients. For patients using no walking aids, a Zimmer frame or 2 walking sticks; equal numbers of patients sustained right and left hip fractures. While 97.7% of patients using 1 walking stick did so in their dominant hand, sustaining 84% contralateral hip fractures.

Conclusions

The direction in which people fall and the causes of hip fractures are clearly multi-factorial. However there is a clear association between hand dominance and the side of hip fracture, particularly in left handed individuals. Walking aids also play a role with 97.7% of patients using a walking stick in their dominant hand resulting in 84% contralateral hip fractures. By being aware of this association it may be possible to target both patient education and physiotherapy potentially reducing the number of patient falls and associated hip fractures.


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