Physiotherapy Management After Distal Humerus ORIF With a Pathological Scar: A Case Report

Abstrak

Background: Pathological postoperative scarring may coexist with pain, edema, weakness, restricted movement, and activity limitations after distal humerus fixation.
Objective: To describe the clinical assessment, physiotherapy management, and short term documented changes in a patient with a pathological postoperative scar and upper limb dysfunction after distal humerus open reduction and internal fixation.
Methods: This single case report involved a 47-year-old woman who received physiotherapy at Tajuddin Chalid Hospital, Makassar, on 30 March, 1 April, and 10 April 2026. Assessment included pain using the Visual Analog Scale, muscle strength, range of motion, scar characteristics using the Vancouver Scar Scale, incision length, arm circumference, and clinical observations. The multimodal program included transcutaneous electrical nerve stimulation, range of motion and strengthening exercises, proprioceptive neuromuscular facilitation, and scar mobilization.
Results: At baseline, movement pain was 8, pressure pain was 9, and resting pain was 0 on the Visual Analog Scale. Right shoulder and elbow muscle strength were 2/5 and 3/5, respectively, and the Vancouver Scar Scale score was 5. After three documented sessions, movement and pressure pain were both 4, while resting pain remained 0. Post treatment measurements for range of motion, muscle strength, scar characteristics, arm circumference, incision length, and quantitative daily activity were unavailable.
Conclusion: The multimodal physiotherapy program was temporally followed by a short-term reduction in documented pain. The single case design, absence of a comparator, incomplete intervention details, lack of follow up, and unavailable post treatment measurements for several outcomes preclude conclusions regarding treatment effectiveness or the effects of individual intervention components.