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Bone mineral density changes in the forearm after immobilization

J P Houde¹, L A Schulz, W J Morgan

¹Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical Center, Worcester 01655, USA.

Clinical Orthopaedics and Related Research

|August 1, 1995

Summary

Forearm immobilization after surgery leads to significant bone loss in the ulna and radius. Bone density did not fully recover even after weeks of therapy, highlighting risks of disuse osteoporosis.

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Area of Science:

Orthopedics
Radiology
Bone Metabolism

Background:

Disuse osteoporosis is a concern following limb immobilization.
Understanding early bone density changes in the forearm is crucial for patient recovery.

Purpose of the Study:

To investigate the early natural history of bone mineral density changes in the ulna and radius following forearm immobilization.
To assess bone recovery after remobilization and hand therapy.

Main Methods:

Bone mineral density was measured using single-energy xray absorptiometry at four sites in the distal radius and ulna.
Measurements were taken before surgery, at cast removal (4.9 weeks), and after remobilization (4.7 weeks).
A control group underwent serial bone density measurements for comparison.

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Main Results:

Patients experienced significant bone mineral density loss at the ulna and distal radius after 4.9 weeks of immobilization.
Bone loss persisted at all measured sites even after 4.7 weeks of remobilization and therapy.
The non-immobilized contralateral forearm showed a temporary increase in bone density, suggesting activity-dependent changes.

Conclusions:

Forearm immobilization after hand or wrist surgery causes significant bone loss in the distal radius and ulna.
Recovery of bone mass may be incomplete even after a period of remobilization and therapy.
Activity in the contralateral limb can influence bone density in the non-immobilized arm.