A contemporary physiotherapy approach to a post-sequestrectomy rehabilitation in an adolescent female

Anushka Mudey, Snehal Samal, Lynn Fernandes, Palak P. Darda, Neha Chitale, Pratik Phansopkar

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

ABSTRACT

Chronic Myelitis results in the pyogenic infection of the bone. In this case, the right tibia was affected and as a result, a Sequestrectomy surgery was carried out, followed by the application of an Ilizarov fixator. Post-operatively, there were various limitations in the ability of the patient to carry out activities of daily living effectively and efficiently. Hence, physiotherapy sessions were initiated in an attempt to bring about improvement in the individual. Patient’s main concerns included pain in her affected leg, inability to flex her knee and difficulty in standing, walking since the occurrence of the operation also difficulty in bed mobility. Pain was 7/10 on numeric pain rating scale during activity and on rest 5/10. The patient was a post-operative case of Sequestrectomy, after being diagnosed with chronic osteomyelitis on the right leg. Her X-rays showed her limb before and after the operation. Physiotherapeutic sessions were begun, that included means of educating the patient and her family, reducing her pain, bringing about normal ROM in the affected joints, strengthening exercises, and finally, gait training. At the end of the physiotherapy sessions, the patient was able to independently walk with a significant improvement in the ROMs of the affected limb. After the hospital sessions, a home program was also recommended to patient with occasional follow-up consultations. The results that compared the before and after physiotherapy sessions showed positive results; which further implies the importance and necessity of physiotherapy in these types of post-operative cases.

Keywords:

Physiotherapy, Rehabilitation, Osteomyelitis, Sequestrectomy, Strength Training, Ambulation Training