Physiotherapy Management After Modified Tension Band Wiring for Comminuted Left Patellar Fracture: A Case Report

Meisya Putri; Immanuel Maulang; Amiruddin

doi:10.24843/

Authors

Meisya Putri Physiotherapy Study Program, Faculty of Nursing, Hasanuddin University, Makassar, South Sulawesi, Indonesia Author
Immanuel Maulang Physiotherapy Study Program, Faculty of Nursing, Hasanuddin University, Makassar, South Sulawesi, Indonesia Author
Amiruddin Physiotherapy Unit, Medical Rehabilitation Department, Dr. Wahidin Sudirohusodo General Hospital, Makassar, South Sulawesi, Indonesia Author

DOI:

https://doi.org/10.24843/

Keywords:

Patellar Fractures, Physical Therapy Modalities, Rehabilitation, Pain, Range of Motion, Articular, Muscle Strength

Abstract

Background: Patellar fracture after open reduction and internal fixation (ORIF) may cause pain, restricted knee motion, muscle weakness, and activity limitations.
Objective: To describe physiotherapy management and clinical changes after ORIF for a comminuted left patellar fracture treated with modified tension band wiring.
Methods: This case report involved a 42-year-old woman with a comminuted left patellar fracture diagnosed in January 2025. ORIF using modified tension band wiring was performed in January, and physiotherapy began in February. Two assessments, on 26 November and 3 December 2025, were available. Interventions included infrared, ultrasound applied to muscles around the knee, active range of motion, manual resistance strengthening, straight leg raises, walking, balance exercise, and home exercise. The knee range of motion target was 0° to 130°, with non-weight bearing for 2 weeks. Outcomes were summarized descriptively.
Results: Movement pain decreased from 5/10 to 4/10 and pressure pain from 3/10 to 2/10. Left knee flexion increased from 70° to 75°, and hamstring strength from 3/5 to 4/5. Circumference 10 cm above the patella increased from 39 to 39.5 cm, while 12 cm below remained 29 cm. Initial observation showed limping gait and supported sit to stand. No standardized functional score was available.
Conclusion: Changes were observed across the two assessments. These findings describe change during multimodal rehabilitation but do not establish treatment effectiveness or causality because of the single case design, limited exposure, short interval, recovery, healing, home exercise, and measurement variability.