Fracture in a Person with Spinal Cord Injury with Heterotopic Ossification due to Improper Exercise in Pandemic: A Case Report

Fractures following inappropriate exercises are rarely reported in Spinal Cord Injury (SCI) population. During pandemic, physical inactivity and barriers to access to rehabilitation facility are conspicuous. Authors report a case of 23-year-old male with femur fracture following improper exercise and its interrelationship with Heterotopic Ossification (HO) and impact of pandemic. Patient reported with American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade C tetraplegia, presented with operated left femur shaft fracture following care-partner administered sudden improper exercise. X-ray of left hip and femur revealed HO around left hip joint and intramedullary nailing of shaft of femur. Routine rehabilitation protocol for SCI was followed especially focusing on safety home-exercise precaution program during pandemic time. To the best of our knowledge, this is the first case report of long bone fracture in a person with SCI following improper exercise which is influence by pandemic situation. Here, authors described the causation of fracture in perspective of the vicious cycle of HO, improper exercise and pandemic impact. Further studies are required to find out appropriate precautionary guidelines regarding exercise during pandemic times for people with SCI.