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Case Reports in Medicine
Volume 2010, Article ID 629020, 4 pages
Case Report

Prolonged Unilateral Disuse Osteopenia 14 Years Post External Fixator Removal: A Case History and Critical Review

1College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, Devon EX4 4QL, UK
2School of Sport and Health Sciences, University of Exeter, EX1 2LU Devon, UK
3Peninsula Medical School, Peninsula College for Medicine and Dentistry, EX2 5AX Devon, UK

Received 6 August 2009; Accepted 17 February 2010

Academic Editor: Thomas J. Zgonis

Copyright © 2010 Karen M. Knapp et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.