Physiotherapy Rehabilitation Strategies for Post-operative Trimalleolar Ankle Fracture: A Case Report

The ankle joint is a complex joint that bears the human body's weight throughout daily activities. Unimalleolar, bimalleolar, and trimalleolar fractures are the three subgroups that make up the category of ankle fractures. Determining the risk-benefit tradeoffs between non-operative and surgical therapy still requires a thorough initial examination of the fracture pattern, soft tissue condition, and patient characteristics. Ankle fractures that are stable and well-aligned respond well to conservative therapy. Open reduction and internal fixation is the current gold standard of treatment for displaced and unstable fracture patterns, with historical data revealing good to outstanding outcomes for the majority of these patients. We present a case of a 19-year-old female sustaining a Pott's fracture following a road traffic accident. The overall treatment technique used included the overload principle, task-specific training, and an impairmentbased strategy. The patient's impairments with regard to the range of motion, strength, edema, discomfort, wound healing, and functional limitations were handled by the therapist using exercises, manual therapy, and compressive cryotherapy. A clinically significant rehabilitation protocol for treating Pott's fracture is established in this case report.

Section: Discussionmentioning

confidence: 99%

A Unique Physical Therapy Approach in a Complex Case of Pott's Fracture: A Case Report

Raipure¹,

Phansopkar²,

Uttamchandani³

2023

“…According to Fokmare et al, the three weeks of physical therapy regimen encompassing proprioceptive training, mulligan's mobilisation with ultrasound therapy, gait training, mobilisation, and strength training, which enhanced the individual's overall functioning, strength and the range of their ankle dorsiflexion in the patients having chronic post-operative trimalleolar ankle fracture [16,17]. The malleolar fracture, which provides good visualisation, proper fracture restoration, and anatomical reduction, can result in reducing complications and improving the final prognosis [18].…”

Section: Discussionmentioning

confidence: 99%

Physiotherapy Management Focusing on Early Mobilisation in Complex Pelvic and Pott’s Fracture

Patil,

Thakre,

Gangwani

2023

Pelvic fractures (PFs), involving the disruption of the bony structures in the pelvic region, are complex injuries often associated with high-energy trauma. Such fractures can significantly impact a patient's mobility and overall quality of life. Concurrently, fractures of the malleoli, specifically the lateral and medial aspects of the ankle, are common lower extremity injuries that can result from various mechanisms, including twisting or direct trauma. This case report presents the multidisciplinary approach employed in the successful treatment of a 26-year-old male patient with a rare combination of PFs involving both anterior and posterior columns, along with lateral and medial malleolus fractures. The patient underwent a series of surgical interventions to stabilise the fractures, followed by a tailored physiotherapy management plan. The report discusses the postoperative care strategies and the crucial role of physiotherapy in the rehabilitation process.

“…Such fractures are categorised as unimalleolar, bimalleolar or trimalleolar fractures according to the number of malleoli that are affected. A type of complicated ankle fracture known as a trimalleolar ankle fracture is composed of a bimalleolar fracture and a posterior malleolar fracture [ 2 ]. Henderson used the phrase 'trimalleolar fracture' for the first time [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Henderson used the phrase 'trimalleolar fracture' for the first time [ 3 ]. The incidence rate is twice as common in females than in males [ 2 ]. Being the most severe type of ankle fracture, it invariably requires immediate surgical intervention for internal fixation and reduction.…”

Section: Introductionmentioning

confidence: 99%

“…In Mulligan's idea of mobilisation with movement (MWM), a type of manual therapy in which the patient engages in an active movement while the therapist applies a gliding force. The objective of applied manual therapy is to rehabilitate the ankle joint as functionally as feasible, providing support to the lower limb to regain its original state [ 2 ]. The majority of studies assessed the functional state of patients following ankle fracture procedures using radiographic findings, physical examination and patient-reported outcome measures [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Comprehensive Physiotherapy Protocol in Post-operative Case of Trimalleolar Fracture: A Case Report

Agrawal,

Thakre,

Deshpande

et al. 2023

A common ankle fracture that can have major consequences and expensive medical bills is the trimalleolar fracture. The trimalleolar fracture is the least frequent type of ankle fracture. The number of afflicted malleoli, the kind of fracture of the lateral and medial malleolus and the congruence of the ankle joint were all examined in detail for the trimalleolar ankle fracture. This type of fracture is brought on by high-energy trauma. In this case report, we describe a 56-year-old female patient who was involved in a road traffic accident. After being taken to the hospital for further examination, her ankle fracture was determined to be a trimalleolar one. She had an internal fixation with canulated cancellous screws and nails for open reduction. For such patients, we designed a physiotherapy course based on early rehabilitation and sensorimotor retraining to help with proprioception training, gait training and lower-limb muscular strength training. The lower limb's strength and range of motion were improved with the treatment. The outcomes used were the numerical pain rating scale (NPRS), functional independence measure (FIM), lower-extremity functional scale (LEFS), range of motion (ROM), gait parameters and manual muscle testing (MMT).