[Immobilization damage]

Prolonged immobilization can threaten the surgical result. The reduction of the muscle diameter is reported to be between 10 and 60% after four weeks of immobilization depending on the different muscle groups. Particularly the oxidative type-1 fibers, the "slow twitch fibers" are concerned. However, the sequelae of immobilization of muscle are reversible, which is in contrast to the detrimental effects immobilization has on the bone. Inactivity osteoporosis is occurring in three stages with bone loss as much as five to twenty times that of other calcipenic disorders. The physiological coupling of bone resorption and bone remodeling is lost. Immobilization leads to arthrosis changing the cartilage matrix composition quantitatively and qualitatively as well as cartilage morphology histologically and electron-microscopically. The result of immobilization is shortening of all fibrous tissues. The loss of the ligament-specific orientation of fibrils leads to significant reduction in tensile strength. The sequelae of immobilization emphasize the importance of early functional therapy. Continuous passive motion speeds up wound healing, and the tissue-structure is improved.