Physiotherapy Management After ORIF for Distal Tibia and Fibula Fracture: A Case Report

Nurul Fitrah Ramadhani H; Irianto; Hermansyah

doi:10.24843/

Authors

Nurul Fitrah Ramadhani H Physiotherapy Profession Study Program, Faculty of Nursing, Hasanuddin University, Makassar, Indonesia Author
Irianto Physiotherapy Profession Study Program, Faculty of Nursing, Hasanuddin University, Makassar, Indonesia Author
Hermansyah Department of Medical Rehabilitation, Dr. Tadjuddin Chalid Central General Hospital, Makassar, Indonesia Author

DOI:

https://doi.org/10.24843/

Keywords:

Distal tibia and fibula fracture, Open reduction and internal fixation, Physiotherapy, Ankle rehabilitation, Range of motion, Gait training

Abstract

Background: Distal tibia and fibula fractures treated with open reduction and internal fixation (ORIF) may cause pain, ankle stiffness, edema, muscle weakness, and impaired mobility. Detailed reports of multimodal physiotherapy with serial clinical outcomes remain limited.
Objective: To describe physiotherapy management and short term clinical outcomes following ORIF for a distal tibia and fibula fracture.
Methods: This case report involved a 38 year old woman assessed approximately two months after ORIF for a left distal one third tibia and fibula fracture. Three physiotherapy sessions on 14, 16, and 22 October 2025 were observed. Treatment included Interferential Current (IFC), ankle pumping, active and passive range of motion (ROM) exercises, isometric exercise, progressive weight bearing, and gait training. Outcomes included Visual Analog Scale (VAS), goniometry, Manual Muscle Testing (MMT), and circumferential measurements. Data were analyzed descriptively.
Results: Palpation pain decreased from 5/10 at T1 to 2/10 at T3, while pain at rest and during movement remained 0/10. Dorsiflexion to plantarflexion changed from 5°–0°–9° to 6°–0°–11°, and inversion to eversion from 22°–0°–20° to 30°–0°–21°. Ankle muscle strength improved from 4−/5 to 4/5. Left ankle circumference decreased from 22 to 21 cm, whereas calf circumference increased from 26 to 26.5 cm. No treatment related adverse events were documented.
Conclusion: Favorable short term changes were observed during three sessions. These descriptive findings do not establish treatment effectiveness or causal effects of individual interventions.