Rehabilitation of supracondylar fracture along with common peroneal nerve injury

Dhanashree Upganlawar, Simran Mishra, Ragini Dadgal*, Om C. Wadhokar, Chaitanya A. Kulkarni, Waqar M. Naqvi

Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India

ABSTRACT

Fractures of the supracondylar and intra-condylar regions of the distal femur are relatively common injuries. Prevalence of hip fractures amongst men in India is most in age group (30-39) i.e. 25 %. Supracondylar femur fractures occur typically due to two discrete mechanism of injury and in two separate populations. Foot drop is the inability to lift the foot up at the ankle (dorsiflex). Depending on the cause, foot drop can be unilateral or bilateral. Foot drop can be caused by a central or peripheral cause. Physiotherapy rehabilitation for post-operative fracture and foot drop has been found effective in most of the cases. Patient present with the complaints of pain which was insidious on onset. Other complaint was swelling at the site of fracture and difficulty in moving right lower limb and performing activities with it. On sensory examination (touch, pain, temperature) of L4, L5,S1, S2 was hyperaesthesia and rest all were normal. On motor examination, complete evaluation of ROM, joint play, reflexes, strength and soft tissue compliances was done. The patient was diagnosed with the injury of common peroneal nerve which leads to foot drop. He also had a fracture due to which he was undergone surgery. Proper skin care, stretching, the use of an orthotic device, electrical stimulation for muscle re-education, strengthening, and desensitisation exercises are all part of the treatment. As an outcome measure, the Foot Ankle Disability Index, Toronto Clinical Neuropathy Scoring System, and NPRS were used. Case study provides comprehensive recovery plan that helped to relieve pain and swelling; improve range, strength and sensory awareness; enhances ability to perform activities of daily living and promotes functional independence. It concludes evidence based and routine physiotherapy rehabilitation is effective in improving status of patients post supracondylar fracture along with foot drop.

Keywords:

Supracondylar femur fracture, common peroneal nerve injury, foot drop, physiotherapy, rehabilitation