Physiotherapy Rehabilitation After ORIF in Scapular and Multiple Rib Fractures: A Case Report

Ana Amaliya Fitri; Wahyuni; Leo Muchamad Dahlan

doi:10.24843/

Authors

Ana Amaliya Fitri Physiotherapy Professional Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia Author
Wahyuni Academic Counselor of Physiotherapy Professional Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia Author
Leo Muchamad Dahlan Dr. Moewardi Regional General Hospital, Surakarta, Central Java, Indonesia Author

DOI:

https://doi.org/10.24843/

Keywords:

Scapular Fractures, Rib Fractures, Physiotherapy, Rehabilitation, ORIF, Shoulder Function

Abstract

Background: Combined scapular and multiple rib fractures are uncommon injuries associated with pain, shoulder dysfunction, respiratory impairment, and functional limitations. Evidence on physiotherapy rehabilitation following Open Reduction Internal Fixation (ORIF) remains limited.
Objective: To describe physiotherapy rehabilitation and changes in pain, shoulder Range of Motion (ROM), muscle strength, thoracic expansion, and functional ability following ORIF.
Methods: A CARE guideline-based case report involved a 55-year-old woman with right scapular and multiple right rib fractures following ORIF. Physiotherapy was provided twice weekly for four weeks, totaling eight sessions, including Transcutaneous Electrical Nerve Stimulation (TENS), therapeutic ultrasound, thoracic mobilization, active-assisted and progressive active exercises, and breathing exercises. Outcomes were assessed using the Numeric Rating Scale (NRS), goniometric ROM, Manual Muscle Testing (MMT), thoracic expansion, and Shoulder Pain and Disability Index (SPADI).
Results: Resting pain decreased from 3/10 to 1/10, tenderness from 9/10 to 5/10, and movement pain from 8/10 to 5/10. Shoulder flexion improved from 80° to 115° and abduction from 80° to 110°. Muscle strength improved from grade 3 to grade 4, while thoracic expansion increased by 2 cm at all measurement levels. SPADI decreased from 82.3% to 68.4%.
Conclusion: A structured physiotherapy program was associated with improvements in pain, shoulder mobility, muscle strength, thoracic expansion, and functional ability following ORIF. Findings should be interpreted cautiously because they are based on a single case.