Multimodal Physiotherapy After Fifth Proximal Phalanx ORIF: A Case Report

Abstract

Background: Postoperative fifth proximal phalanx fractures treated with open reduction and internal fixation (ORIF) commonly result in pain, joint stiffness, reduced range of motion (ROM), muscle weakness, and impaired hand function. Physiotherapy plays a crucial role in restoring functional capacity.

Objective: To evaluate the clinical outcomes of a multimodal physiotherapy intervention on pain, ROM, muscle strength, and functional ability in a patient following ORIF of the fifth proximal phalanx.

Methods: This study was a single-case report involving a 22-year-old female patient with a left fifth proximal phalanx fracture following ORIF. The intervention was conducted over three weeks (three sessions per week), with assessments performed at baseline (T0) and weekly until T3. Outcome measures included the Numeric Rating Scale (NRS) for pain, goniometric measurement for ROM, Manual Muscle Testing (MMT) for muscle strength, and the Wrist Hand Disability Index (WHDI) for functional ability. Data were analyzed descriptively.

Results: Pain at rest decreased from 2/10 to 0/10, movement pain from 5/10 to 3/10, and tenderness from 6/10 to 4/10. MCP joint ROM improved from S 10°–0°–60° to 15°–0°–70°. Muscle strength increased from grade 3/5 to 4/5. Functional disability improved from 54% (moderate disability) to 40% (minimal disability). These findings indicate clinically meaningful improvement despite residual limitations.

Conclusion: A multimodal physiotherapy program consisting of infrared therapy, ultrasound, paraffin bath, and active-assisted exercise was effective in improving clinical outcomes and hand function in a patient following ORIF of the fifth proximal phalanx.