Multimodal Physiotherapy for Post-ORIF Tibial Plateau Fracture: A Case Report

Alviana Rohali; Totok Budi Santoso; Kingkinnarti

doi:10.24843/mifi.000001747

Authors

Alviana Rohali Professional Physiotherapy Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia Author
Totok Budi Santoso Professional Physiotherapy Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia Author
Kingkinnarti Physiotherapist, RSUD Dr Harjono Ponorogo, Indonesia Author

DOI:

https://doi.org/10.24843/mifi.000001747

Keywords:

Tibial Plateau Fractures, Physical Therapy Modalities, Range of Motion, Rehabilitation, Knee Joint

Abstract

Background: Tibial plateau fractures are intra-articular injuries frequently associated with postoperative knee stiffness following open reduction and internal fixation (ORIF). This condition may lead to pain, restricted range of motion (ROM), muscle weakness, and impaired functional outcomes. Early structured physiotherapy is essential to minimize disability and optimize recovery.

Objective: To report the clinical outcomes of a multimodal physiotherapy program in a patient with knee stiffness following ORIF for a Schatzker type II tibial plateau fracture.

Methods:mThis case report was prepared in accordance with CARE guidelines. An 18-year-old female with post-ORIF tibial plateau fracture (right knee, Schatzker II) underwent six sessions of outpatient physiotherapy. Interventions included infrared therapy, proprioceptive neuromuscular facilitation (hold–relax), active exercise, quadriceps setting, and progressive early weight bearing. Outcomes were assessed using the Numeric Rating Scale (NRS), knee ROM (goniometer), Manual Muscle Testing (MMT), and International Knee Documentation Committee (IKDC) score.

Results: After six sessions, movement pain decreased from 6/10 to 3/10 (Δ = −3). Knee flexion ROM improved from 50° to 85° (Δ = +35°), while passive ROM increased from 80° to 105° (Δ = +25°). Quadriceps strength improved from MMT grade 3+ to 4. IKDC score increased from 25% to 38% (Δ = +13%). These changes indicate clinically meaningful improvements in pain, mobility, and functional performance.

Conclusion: Multimodal physiotherapy was associated with improvements in pain, ROM, muscle strength, and knee function in the early postoperative phase following ORIF tibial plateau fracture. However, findings should be interpreted cautiously due to the single-case design.