Early-Stage Physical Therapy for a Patient With Proximal Tibial Fracture With Acute Compartment Syndrome and Neurovascular Deficits Managed With External Fixation Complicated by Chronic Osteomyelitis: A Case Report

Abstract

Tibial fractures occur following low-energy and high-energy trauma resulting from indirect and direct impacts, respectively. High-velocity trauma like road traffic accidents usually results in open fractures of the tibia associated with acute compartment syndrome, posing a serious threat. Thus, this injury requires prompt operative management with fasciotomy followed by fixating the fracture with an external fixator to avoid infection. Despite all the efforts, sometimes this condition may lead to osteomyelitis of the tibia requiring further care. Meanwhile, the patient has to be kept immobilized for a longer duration of time, which allows further complications to occur. Therefore, structured physiotherapeutic management of patients postoperatively is of immense necessity to prevent complications associated with prolonged immobility and achieve an optimal level of functional independence, thereby facilitating the patient to come back to near-normal life as soon as possible. Our case report provides a structured early-stage postoperative physical therapy treatment protocol for a patient with a proximal tibial fracture with acute compartment syndrome and neurovascular deficit managed with Ilizarov fixation.

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

“…Ilizarov fixation is used to surgically treat foot drop deformity and neurovascular impairment. In order to manage the patient with persistent osteomyelitis during the early stages of physiotherapy, the case study provides a structured approach [ 12 ]. Mundada et al outline an extensive rehabilitation strategy considering individuals with chronic osteomyelitis treated with an Ilizarov ring fixator and sequestrectomy in this case report.…”

Improving Healing: The Putative Effects of Low-Level Laser Therapy for Ulcer in Parkinson's Disease

“…According to Daf et al, by combining physiotherapy and surgical alternatives, ankle-foot orthosis (AFO), or functional electrical stimulation (FES) may be used to deliver interventions that are precisely tailored to meet the individualized needs of their patients [ 13 ]. Eccentric-based resistance exercises, in particular, are beneficial in the treatment of tremors [ 14 ].…”

Rehabilitation Techniques for Adults Undergoing External Fixation Treatment for Lower Limb Reconstruction: A Systematic Review

“…Strengthening is a key part of rehabilitation after lower limb trauma and was the second most common theme of the interventions, reported in nine out of 15 papers. 6 , 19 , 20 , 23 , 26 , 27 , 31 , 33 , 34 However, poor reporting and the low CERT scores of the included articles are challenging as there is limited information regarding repetitions, sets, and frequency. Therefore, many of the exercises reported as strengthening may have not been defined as strengthening exercises under the American College for Sports Medicine guidelines.…”