Source of Support: None, Conflict of Interest: None
This study presents observations based upon three cases of long bone fractures treated by internal fixation. These patients recovered without any complications, but soon after trivial fall resulted in a fracture at a different site than the previous one. This study tries of explore the possible reasons for such a happening. The probable causes include damage to the vascular supply of the long bone due to initial fracture, soft tissue injury due to initial trauma, surgical intervention and internal fixation with implants. This triggers a remodeling phase in the Haversian system thereby weakening the bone resulting in decreased critical strain of the involved bone. The implants and the screw holes in bone act as stress risers. This alters the even load distribution mechanism of the long bone. Trivial falls sustained by the patient during recovery period after fixation results in loads exceeding the critical strain causing fracture of the already operated long bone. Preventive measures like minimal damage to soft tissues during surgery and implant fixation, use of LCDCP type plates to preserve maximum blood supply of bone, adequate splinting during recovery phase of bone healing, and once bony union is adequate implant removal to restore the even load distribution mechanism in long bones are suggested.