Huda Fajar AriantoUniversitas Airlangga Hospital, Indonesia
Title: Early weight bearing for stress shielding and bone osteoporosis : a case series
Background: As human life expectancy increasing globally, the musculoskeletal capability continue to wane as impact of sedentary lifestyle, resulting in osteopenia and osteoporosis and led to low-energy fractures. Bone implant could made stress shielding and it worsen the bone condition.
Case: We present a three cases of re-fracture of the femoral bone, after trivial fall and even a casual walk in a young age and two older female. All of them undergoing implant removal surgery a week before or a several months before they got fracture again. The open surgery with internal fixation was made for all of them, and directly continue to the rehabilitation for get the best performance after surgery.
Discussion: Following Wolf’s Law, a stress shielding in a bone with implant characterized by its adaptation to the changed stress distribution, resulting in thinner bone or more porous bone. These resorptive processes could rise the collapse of the plate and increasing the risk for fracture caused by cantilever loading. Early discharged continue with early weight bearing training for femoral fractures were associated with highest improvement bone healing for daily activities.
Conclusion: Fixed and rigid implant could make stress shielding phenomena, in which the bone resorption take place due to disuse osteopenia. We consider that maximizing the weight bearing training programs could start very early to encourage better bone healing faster.
Keywords : Osteopenia, Osteoporosis, Fractures, Stress Shielding, Weight Bearing.
Huda Fajar Arianto, was an intern general practitioner at Department of Orthopedics in Universitas Airlangga Hospital in 2021-2022. He was graduated from Hang Tuah Medical School in 2020 and continuing the Government Internship Program for 9 months. Until today he had 1 journal publication and pursuing his future Orthopedics Residency Program.