Multimodal Physiotherapy Treatment Following Supracondylar Fracture of the Femur: a Case Report
Abstract
ABSTRACT Background: Intercondylar comminuted supracondylar femur fractures can cause postoperative pain, stiffness, restricted ROM, muscle weakness, and impaired mobility. Prolonged immobilization may worsen these limitations. Consistently physiotherapy can improve knee mobility, strength, balance, gait, and functional independence following ORIF with bone grafting and MUA. Objective: To evaluate the effectiveness of progressive physiotherapy rehabilitation on postoperative knee stiffness, pain, range of motion, muscle strength, gait, and functional independence following ORIF with bone grafting and manipulation under anesthesia Case description: A 20-year-old male sustained a comminuted left distal femur fracture following a road traffic accident. He underwent ORIF with a locking compression plate, followed by bone grafting and manipulation under anesthesia due to persistent postoperative knee stiffness. Initial assessment demonstrated severe pain (NPRS 9/10), active knee flexion of 30°, passive knee flexion of 45°, quadriceps and hamstring strength of Grade 2+, and poor functional status (LEFS 28/80). Intervention: The patient underwent an individualized 9-week progressive physiotherapy rehabilitation program consisting of cryotherapy, patellar mobilization, active-assisted ROM exercises, CPM , Mulligan and Maitland mobilization, muscle energy techniques, scar mobilization, dry needling, cupping therapy, paraffin wax therapy, progressive resistance strengthening, lower-limb stretching, balance and proprioceptive training, gait training, weight-shifting exercises, and open and closed kinetic chain functional exercises. Result: Pain reduced to 3/10, active knee flexion improved to 100°, passive flexion to 120°, muscle strength improved to Grade 5, and LEFS improved from 28/80 to 70/80, indicating better functional mobility Conclusion: A 9-week progressive physiotherapy rehabilitation program effectively reduced postoperative knee stiffness, improved knee ROM, muscle strength, functional mobility, and overall independence. Keywords: Distal femur fracture, ORIF, Bone grafting, MUA, Knee stiffness, Consistently Physiotherapy rehabilitation, Dry needling, Cupping therapy.