Prolonged unilateral disuse osteopenia 14 years post external fixator removal: a case history and critical review.
Disuse osteopenia is a complication of immobilisation, with reversal generally noted upon remobilisation. This case report focuses on a patient who was seen 18 years following a road traffic collision when multiple fractures were sustained. The patient had an external fixator fitted for a tibia and fibula fracture, which remained in situ for a period of 4 years. Following removal, the patient was mobilised but, still required a single crutch to aid walking. Fourteen years post removal of the fixator, the patient had a DXA scan which, demonstrated a T-score 2.5 SD lower on the affected hip. This places the patient at an increased risk of hip fracture on this side, which requires monitoring. There appear to be no current studies investigating prolonged disuse-osteopenia in patients following removal of long-term external fixators. Further research is required to quantify unilateral long-term effects to bone health and fracture risk in this population.
Knapp
Karen M
KM
College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, Devon EX4 4QL, UK.
Rowlands
Ann V
AV
Welsman
Joanne R
JR
Macleod
Kenneth M
KM
Nutrition. 2002 Oct;18(10):853-6
12361778
J Musculoskelet Neuronal Interact. 2006 Oct-Dec;6(4):319-21
17185806
Skeletal Radiol. 1986;15(2):129-32
3961518
J Bone Joint Surg Br. 1993 Nov;75(6):914-7
8245081
Paraplegia. 1995 Nov;33(11):669-73
8584303
Calcif Tissue Int. 1984;36 Suppl 1:S151-44
6430516
J Bone Miner Res. 1995 Jan;10(1):112-8
7747617
J Shoulder Elbow Surg. 1996 Nov-Dec;5(6):471-6
8981273
J Bone Miner Res. 1995 Mar;10(3):496-505
7785472
Calcif Tissue Int. 2005 Jun;76(6):404-11
15812577
J Am Paraplegia Soc. 1992 Jul;15(3):163-70
1500942
J Bone Miner Metab. 2006;24(4):291-9
16816923
AJR Am J Roentgenol. 1987 Aug;149(2):329-32
3496759
Osteoporos Int. 2000;11(12):985-1009
11256898
Metabolism. 2008 Feb;57(2):226-32
18191053
Ir Med J. 2005 May;98(5):141-2
16010781
BMC Musculoskelet Disord. 2006 Nov 30;7:92
17137514
J Pediatr Orthop. 2005 May-Jun;25(3):326-31
15832148
Osteoporos Int. 2005 Mar;16(3):302-5
15197547
Injury. 1995 Sep;26(7):459-62
7493783
Keio J Med. 2005 Jun;54(2):55-9
16077253
Hormones (Athens). 2005 Jan-Mar;4(1):18-27
16574628
Arch Orthop Trauma Surg. 1986;105(5):268-73
3778161
Foot Ankle Clin. 2008 Mar;13(1):1-13, v
18328413