Underimmobilization

Underimmobilization refers to insufficient or inadequate immobilization of an injured limb or joint following trauma or surgery. The term is used primarily in orthopaedic and rehabilitation contexts to describe situations where a cast, splint, brace or other device does not adequately restrict motion, allowing unintended movement that can impede healing. Underimmobilization can occur when the device is too loose, the material chosen is inadequate for the type of injury, or the duration of immobilization is shortened prematurely. It may also result from poor fitting of custom-made equipment or inadequate patient compliance.

In fractures, underimmobilization can lead to malunion, non‑union, decreased bone density, and joint stiffness. In ligamentous injuries, it may permit excessive micro‑motion that compromises the repair or reconstruction, increasing the risk of reinjury. In postoperative contexts, such as after total joint arthroplasty or tendon repair, inadequate immobilization may provoke hardware loosening or tendon rupture. The phenomenon is often identified through imaging, functional testing, or clinical observation of abnormal gait or joint mechanics.

Preventing underimmobilization requires careful assessment of injury severity, choice of appropriate immobilization devices, and clear patient education. Surgeons and therapists routinely monitor immobilization devices for fit and integrity, adjust protocols based on healing stage, and reinforce compliance. Evidence from clinical studies underscores the importance of optimal immobilization in promoting bone consolidation, reducing pain, and restoring function.