Physiotherapy Management After ORIF for Proximal Femur Fracture: A Case Report

Abstrak

Background: Proximal femur fractures may cause pain, restricted range of motion, muscle weakness, and impaired function after surgical fixation. Detailed reporting of individualized physiotherapy during early postoperative rehabilitation remains limited.
Objective: To describe physiotherapy management and serial clinical changes in a patient with a right proximal femur fracture after open reduction and internal fixation (ORIF).
Methods: This case report followed the CARE reporting framework. A 59-year-old woman underwent ORIF with plate and screw fixation after a motorcycle accident. Physiotherapy was delivered across three sessions and included positioning, ankle pump exercise, interferential therapy, diaphragmatic breathing, active assisted range of motion, isometric exercise, activity modification education, and walking exercise with a walker. Pain, active and passive range of motion, manual muscle testing, and the Lower Extremity Functional Scale (LEFS) were assessed serially.
Results: Rest pain decreased from 4 to 0, movement pain from 7 to 2, and palpation pain from 9 to 3. Active and passive hip flexion increased from 40° to 85° and 50° to 95°, respectively. Active and passive knee flexion increased from 30° to 60° and 45° to 85°. Selected hip and knee muscle strength grades improved. LEFS increased from 4 to 20, representing an absolute change of 16 points.
Conclusion: Improvements in pain, joint motion, muscle strength, and lower extremity function were observed during rehabilitation. However, the single case design, multimodal intervention, and short follow up preclude causal attribution to individual interventions and limit generalizability.