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Challenges of Physiotherapy Management: Type 4 Knee Arthrofibrosis Following Traumatic Multiple Structural injuries of Knee in a 16-year Old Boy: A Clinical Case Report

Case reports

Abstract

Traumatic knee crush injuries of degloving nature carries a greater risk for the multitude of complications rendering emergency  surgical  intervention  the  treatment  of  choice  in  the  majority  of  such  injuries.  These  types  of  injuries commonly result in a unique post- operative complication such as arthrofibrosis and it presents overly challenge for Physiotherapists  managing  it.  In  this retrospective  single-case  report,  we  describe  the  challenges  of  in –  and  out- patient  physiotherapy  treatment  planning  for  a  16-year  old  boy  throughout  the  continuum  of  care  for  his  knee arthrofibrosis following a series of surgical procedures. As result of his complex medical situation, the time-specific physiotherapy intervention during the immediate post-operative period failed to improve our patient’s knee function. The  knee  function  with  regard  to  range  of  motion  (  especially  extension),  muscle  strength(quadriceps)  improved considerably  with  the  adoption  of  an  aggressive  physiotherapy  intervention  approach  that  included  specific quadriceps muscle strengthening,  joint mobilization (rotation/traction) in sitting position with legs over the edge of table and contract-relax quadriceps stretching in prone position using theraband.