Hand Dominance and Walking Aid Use – Pre-determinants for Hip Fracture in the Elderly?

AIM: 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. MATERIALS AND METHODS: Two separate 6-month prospective reviews of hip fracture patients aged over 65 years of age were conducted at two different hospitals, with the second review focusing on walking aid use. The patients with a 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. A total of 91 patients were excluded from the study. Of the remaining 248 patients, 2.06 times as many fractured their hip on the side of their non-dominant hand. For the left-handed individuals this increased to 4.6 times. Walking aid use was recorded for 102 patients. Equal numbers of the right and left hip fractures were sustained for patients using no walking aids, a Zimmer frame or two walking sticks; while 97.7% of patients using one walking stick did so in their dominant hand, sustaining 84% contralateral hip fractures. CONCLUSION: The direction in which people fall and the causes of hip fractures is clearly multifactorial. However, we did find an association between hand dominance and hip fracture, especially when using a single walking aid. 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.