Progressive Rehabilitation After Intramedullary Nailing of a Proximal Femur Fracture: A Case Report

Mawaddah Warahmah; Irianto; Hermansyah

doi:10.24843/

Authors

Mawaddah Warahmah Physiotherapy Professional Study Program, Faculty of Nursing, Hasanuddin University, Makassar, South Sulawesi, Indonesia Author
Irianto Physiotherapy Professional Study Program, Faculty of Nursing, Hasanuddin University, Makassar, South Sulawesi, Indonesia Author
Hermansyah, S.ST. Ftr Physiotherapy Unit, Medical Rehabilitation Department, RSUP Dr. Tadjuddin Chalid Makassar, Indonesia Author

DOI:

https://doi.org/10.24843/

Keywords:

Proximal Femur Fractures, Intramedullary Nailing, Rehabilitation, Physical Therapy, Case Reports

Abstract

Background: Proximal femur fractures may cause pain, restricted range of motion (ROM), muscle weakness, and impaired weight-bearing capacity. Progressive physiotherapy may address these impairments following surgical fixation.
Objective: To describe changes in pain, ROM, muscle strength, and thigh circumference following progressive physiotherapy after intramedullary nailing for a proximal femur fracture.
Methods: This case report involved a 46-year-old man with a displaced oblique fracture of the proximal third of the left femur following a slip and fall. Intramedullary nailing was performed on October 3, 2025. Approximately one month postoperatively, he received four physiotherapy sessions twice weekly, comprising therapeutic exercise, progressive strengthening, balance and weight-transfer training, gait training, knee joint traction, and transcutaneous electrical nerve stimulation. Outcomes included Visual Analogue Scale (VAS) pain, hip and knee ROM, manual muscle testing, and upper-thigh circumference.
Results: After four sessions, VAS scores decreased by 1 point for resting, movement-related, and pressure pain. Left hip and knee flexion increased by 5° and 10°, respectively. Hip muscle strength improved from 3/5 to 4/5, while knee and ankle strength remained 4/5. Upper-thigh circumference remained unchanged at 38 cm. No inferential statistical analysis was performed.
Conclusion: Progressive physiotherapy was accompanied by improvements in selected pain, ROM, and hip strength measures. These descriptive findings do not establish treatment efficacy or causality.