RESUMEN
The posterior cruciate ligament (PCL), one of the key ligaments in the knee, serves to prevent backward movement of the tibia relative to the femur. A simultaneous occurrence of a PCL avulsion fracture and a femur shaft fracture in a pediatric patient suggests a complex orthopedic injury resulting from significant trauma to the knee and thigh area. This study describes the rehabilitation process of a 12-year-old female involved in a road traffic accident, who suffered both a midshaft femur fracture and a PCL avulsion fracture. Following surgical procedures, the patient underwent a comprehensive physiotherapy regimen utilizing X-Sens inertial sensor technology. The rehabilitation plan comprised multiple stages targeting pain alleviation, muscle strengthening, flexibility exercises, gait retraining, and balance improvement. Various interventions including contrast baths, cryotherapy, patellar mobilization, isotonic and resistance exercises, and progressive gait training were integrated across different phases of the rehabilitation program. Over subsequent follow-up periods, the patient demonstrated significant enhancements in pain management, range of motion, muscle strength, functional capabilities, and gait metrics. This case report underscores the efficacy of a systematic physiotherapy strategy incorporating advanced technology in the successful recovery from intricate lower limb fractures, underscoring the importance of prompt intervention and multidisciplinary collaboration for optimal patient outcomes.
RESUMEN
In patients who undergo femoral fracture fixation with a cephalomedullary nail, the breakage of one or more of the distal interlocking screws is a well-described phenomenon. The presence of a broken interlocking screw in patients who require the removal of their cephalomedullary nail presents a unique challenge. The broken interlocking screw may be retrieved, or the screw may be retained if it is not engaged within the nail and the nail can safely be removed while leaving the broken screw fragment behind. We report a hip conversion arthroplasty case with a broken interlocking screw where the nail was removed with ease and the broken screw was assumed to have been left behind. Cerclage wires were placed for an apparent proximal femoral fracture. Postoperative X-rays demonstrated a large lucency tracking from the prior location of the distal interlocking screw to the calcar region. This finding made it evident that the broken screw had been retained in the nail and was dragged up the femur upon nail removal, causing a large gouge spanning the entire femur.
RESUMEN
Kinesiophobia is an irrational and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re-injury. According to the concept of avoidance of fear, pain is interpreted as threatening, which can trigger pain-related fears and anxiety leading to avoidance behavior. Avoidance action involves a process/period characterized by a person stepping back from undertaking daily tasks like exercise, socializing, and work, which increases the intensity of the painful experience. In hospital settings, kinesiophobia needs to be resolved to ensure a positive result in rehabilitation interventions. The femur is the lower extremity's primary weight-bearing bone. Early fracture fixation in the shaft of the femur allows for early mobilization, thereby reducing the risk of hip and knee stiffness as well as quadriceps and hamstring wasting. In this report, we present the case of a 16-year-old girl with an alleged history of fall who was admitted to Acharya Vinobha Bhave Rural Hospital (AVBRH), Datta Meghe Institute of Medical Sciences (DMIMS) Deemed To Be University (DU), Wardha, India, with primary complaints of pain and swelling over the left thigh. She was diagnosed with a left midshaft femur fracture. An open reduction internal fixation (ORIF) femur interlock nailing was performed to stabilize the fracture, and she was referred to physiotherapy after surgery for further management. The comprehensive rehabilitation program was helpful in alleviating the severe kinesiophobia in the patient, and she was able to resume her activities of daily living (ADLs) independently.