Proximal tibia fractures are generally open fractures resulting in life-threatening complications. There is an increase in the prevalence of compartment syndrome post-tibial fractures. Though fasciotomy and wound debridement is the choice of treatment in such conditions, amputation becomes a necessity when there is widespread muscle and tissue damage. Specifically, compartment syndrome involving the lower limb is distressing as its symptoms can be misleading at times resulting in delayed diagnosis and hence lifethreatening complications. A 48-year-old male met with a road accident and presented to the hospital with complaints of pain and an open wound over the anterior aspect of the right lower leg 14 days ago. He was managed by Ilizarov external fixator. Later he developed compartment syndrome as a complication of tibial plateau fracture, for which decompressive fasciotomy was performed. But due to irreversible tissue loss and gangrene, he had to undergo above-knee amputation followed by physiotherapy rehabilitation. We mainly focused on postoperative/pre-prosthetic rehabilitation. During postoperative rehabilitation, we concentrated on reducing phantom limb pain, preventing complications, and improving strength and endurance. Current literature claims that mirror therapy is effective in reducing phantom limb pain in post amputees, but there are only a few case reports emphasizing mirror therapy in particularly lower limb amputees. Therefore, we emphasized using mirror therapy for phantom limb pain in this case of lower limb amputation. It resulted in positive outcomes. Our broader aim was to strengthen the upper limbs and the intact lower limb so that the patient's overall functional independence can be enhanced. Further prosthetic rehabilitation was planned in which we focused on gait and balance training. Physiotherapy rehabilitation improved the patient's quality of life and independence.

Down syndrome (DS) is characterized by the presence of all or a portion of the third chromosome 21. In this population, congenital heart disease (CHD) is the primary cause of death and morbidity in the first two years of life. Atrioventricular septal defect (AVSD) is the most common CHD seen in DS patients, followed by an atrial septal defect (ASD), ventricular septal defect (VSD), and tetralogy of Fallot (TOF). There is a high possibility of serious cardiac abnormalities in DS patients thus; there must be a protocol in place for early screening, prompt diagnosis and early operative measures. Due to advancements in technique and postoperative care over the last few years, the prognosis following surgical repair has substantially improved. Most of the post-operative strategies for patients with CHD can be applied to patients with DS. Physiotherapists play an important role in managing patients after the surgical repair of cardiac abnormalities. They also help in facilitating physical activity in children with DS. Our case report aims to provide the post-operative physiotherapy protocol for a child with DS operated for the closure of ASD and VSD along with the ligation of Patent Ductus Arteriosus (PDA). The main aim of post-operative cardiac and respiratory physiotherapy management was to clear lung secretions, promote healthy healing of the incision, maintain patency of lungs, reduce work of breathing and improve chest mobility while addressing delayed developmental milestones. The case report illustrates the importance of inpatient post-operative physiotherapy management which will lead to a gain in the existing knowledge while dealing with such patients.