Case Report: Progressive Exercise Improves ROM and Strength in Late-Phase Post-ORIF Tibial Plateau Fracture

Gatra Azzuma Wicaksana; Suryo Saputra Perdana; Reza Arshad Yanuar

doi:10.24843/mifi.000001797

Authors

Gatra Azzuma Wicaksana Professional Physiotherapy Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Central Java, Indonesia Author
Suryo Saputra Perdana Department of Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Central Java, Indonesia Author
Reza Arshad Yanuar Department of Physical Medicine and Rehabilitation, RSUD Kota Salatiga, Salatiga, Central Java, Indonesia Author

DOI:

https://doi.org/10.24843/mifi.000001797

Keywords:

Tibial Plateau Fractures, Exercise Therapy, Range of Motion, Articular, Fracture Fixation, Internal

Abstract

Background: Tibial plateau fractures are complex intra-articular injuries often associated with joint stiffness, muscle weakness, and functional limitations following open reduction and internal fixation (ORIF).

Objective: To evaluate the effectiveness of progressive exercise in improving range of motion (ROM), muscle strength, pain, and functional independence in a post-ORIF patient.

Methods: This case report involved a 30-year-old male five months after ORIF due to trauma. A six-week progressive exercise program based on the FITT principle was implemented, including isometric exercise, active ROM, resistance training progressing from open to closed kinetic chain, and functional training. Outcomes were assessed using Numeric Rating Scale (NRS), goniometry, Manual Muscle Testing (MMT), and the Barthel Index.

Results: Knee flexion ROM improved from 70° to 80°, muscle strength increased from 4-/5 to 4/5, and pain decreased from 5/10 to ≤3/10 during activity. The Barthel Index improved from 79 to 90, indicating enhanced functional independence. No adverse events were reported.

Conclusion: Progressive exercise appears to be a safe and beneficial approach for improving mobility, strength, pain, and functional outcomes in late-phase post-ORIF rehabilitation. This case highlights the importance of structured progressive rehabilitation in addressing persistent functional limitations during the late postoperative phase.