Early Physiotherapy as an Adjunct to Surgical Approach in Case of Chronic Tibial Osteomyelitis Treated with Sequestrectomy and an Ilizarov Ring Fixator in a 14-Year-Old Schoolgirl: A Case Report

Abstract

Osteomyelitis is an infectious disease of the bone and bone marrow caused by pyogenic organisms that may be acute or chronic. Early diagnosis and treatment prevent complications like limb deformity and limb length discrepancies. A 14-year-old girl presented to the orthopedic department with complaints of pain, fever, swelling, tenderness, and pus discharge across the right leg below the knee. Previously, she visited a local hospital where after initial investigations, she underwent saucerization followed by antibiotic bead application. After experiencing no improvements, she came to Acharya Vinoba Bhave Rural Hospital, Sawangi Meghe, Wardha. After investigations, she was confirmed to have chronic right tibial osteomyelitis, after which she underwent sequestrectomy with an Ilizarov Fixator application. After three months, she started experiencing pain over the right leg, discharge from the wound site, on and off fever, and difficulty walking, for which she was again admitted to this hospital. She was primarily managed by dressing and medication and subsequently received physiotherapy intervention with proper rehabilitation protocol which was found to be very effective in achieving functional mobility and independence. This case study concludes that a multidisciplinary team involving a definitive surgical approach and physiotherapy rehabilitation protocol which resulted in improved functional mobility and independent ambulation for the patient, which plays a significant role in a fast and successful recovery.

A Comprehensive Physiotherapeutic Intervention for Complex Proximal Tibia Fracture With Ilizarov Fixator and Foot Drop in 18-Year-Old Adult: A Case Report

“…The case study comes to the conclusion that the patient's functional independence and ambulation were enhanced by an interdisciplinary group that included a specific surgical approach and customized physiotherapy rehabilitation. As it facilitates a speedy and full recovery, this is important [ 13 ]. Shahade et al used an Ilizarov external ring fixator in an operative case comprising a 10-month-old malunited supracondylar fracture of the femur, osteomyelitis, and a proximal tibia-fibula fracture with right-sided foot drop.…”

The Role of Physiotherapy in Chronic Osteomyelitis of the Second Metatarsal for the Restoration of the Functions in a 20-Year-Old Patient: A Case Report

“…The outcomes of the case study underscore the effectiveness of a multidisciplinary approach, integrating definitive surgical interventions with tailored physiotherapeutic rehabilitation, resulting in significant improvements in the patient's functional autonomy and ambulatory prowess [ 16 ]. These advancements notably accelerate the recovery process, facilitating swift and favorable rehabilitation outcomes.…”

“…Phase-wise rehabilitation protocol for eight weeksReference:[16] UL: upper limb; LL: lower limb; NWB: non-weight bearing; TTWB: toe-touch weight bearing; PWB: partial weight bearing; FWB: full weight bearing; BD: twice a day; TD: thrice a day; reps: repetitions; secs: seconds; AAROM: active assisted range of motion; SLR: straight leg raise…”

Physiotherapy Intervention Focusing on Proprioceptive Retraining for Tibial Pseudoarthrosis Patients Operated With Ilizarov External Fixator: A Case Report

“…The case study carried out by Mundada et al describes an extensive physiotherapy rehabilitation program for patients undergoing an Ilizarov ring fixator and sequestrectomy for chronic osteomyelitis. In this instance, there was a significant improvement over the course of the eight weeks of rehabilitation, including a safe return to normal activities, improvements in ROM, muscular strength, pain relief and gait, and prevention of secondary impairments [ 13 ].…”