When do fractures frequently occur in those with spina bifida?

• A. After surgery
• B. During intensive athletic activity
• C. During normal daily activity
• D. During sleep

Answer: (A)

Fracture risk in spina bifida is driven by weaker bones from limited weight-bearing and disuse. When surgery is done, the affected limb or area is typically immobilized for a period with casts or braces, and overall activity levels drop during recovery. This immobilization leads to further bone loss (disuse osteopenia), so the bones become more fragile. Once rehabilitation begins and normal activity resumes, these weakened bones are more prone to fracture from stresses that wouldn’t break healthier bones. That combination of temporary bone loss and subsequent return to activity makes fractures most likely in the postoperative period.

In comparison, intense athletic activity is not as common for many with spina bifida, daily activities are usually carried out within adapted limits, and fractures during sleep are rare.