Physiotherapy Management After Clavicle Fracture ORIF: A Case Report

Abstract

Background: Clavicle fractures may require open reduction and internal fixation (ORIF). After surgery, patients may experience pain, restricted shoulder range of motion (ROM), reduced muscle strength, and limitations in daily activities.
Objective: To describe physiotherapy management and clinical changes in a patient following ORIF for a clavicle fracture.
Methods: This case report involved a 49-year-old man with a right clavicle fracture following a traffic accident. Physiotherapy was initiated 9 days after surgery; however, this report analyzed 30 sessions conducted over 19 weeks, from September 16, 2025, to January 26, 2026. The multimodal program included transcutaneous electrical nerve stimulation, passive, active-assisted, and active ROM exercises, stretching, scapular mobilization, isometric shoulder strengthening, and home exercises. Outcomes included pain measured using the Visual Analog Scale, shoulder ROM, muscle strength assessed using Manual Muscle Testing, and the ability to reach the back during bathing.
Results: Flexion increased from 125° to 160°, extension from 30° to 60°, abduction from 110° to 160°, adduction from 20° to 50°, internal rotation from 50° to 70°, and external rotation from 40° to 90°. Muscle strength improved from grade 4− to grade 5. Movement pain decreased from 5 to 2, resting pain from 3 to 1, and tenderness from 3 to 1. The patient independently reached his back during bathing at the final assessment.
Conclusion: Improvements in pain, shoulder ROM, muscle strength, and the observed self-care activity were documented during the observation period. However, a causal relationship between the intervention and these changes cannot be established.