Case Study – Open Reduction Internal Fixation of the Humerus

March 17, 2018 | By | Reply

Ruchi (name changed), 38-year-old female, came to PhysioRehab for rehabilitation post ORIF (open reduction internal fixation) surgery of the left (L) humerus (upper arm). She handles her family business from her home, as well as doing household chores, while raising 2 kids. She needs to use her hand for all daily activities. Her younger son is 1.5 years old, and she has to constantly pick him up.

On the day of assessment her complaints were:

  • Unable to bend and completely straighten her elbow.
  • Difficulty in lifting even 1/2 kg of weight.
  • Difficulty in grooming (e.g. combing, dressing/undressing etc.)
  • Unable to use the laptop, as she couldn’t bend her elbow.

Ruchi had met with an accident where she had hit her arm on the wardrobe, in May 2017, due to which the arm was fractured in multiple places. She underwent ORIF, and her arm was fixed with plates and screws. Post-surgery she was advised to achieve minimum 90 degrees of range at the elbow joint and was referred to PhysioRehab by her surgeon.

At PhysioRehab, a holistic assessment was done. After this assessment, the following points were observed:

  • Elbow range: 40-60 degrees.
  • Initiation of stiffness in the shoulder joint.
  • Overall weakness of shoulder and elbow muscles.
  • Apprehensive about recovery and pain tolerance.

She was given detailed explanations regarding the problem areas and the importance of improving the range of motion (ROM) of the elbow. Achieving adequate ROM was necessary, otherwise Ruchi would have to undergo manipulation under anaesthesia, which is risky in the case of the elbow joint. A tailor-made program was made at PhysioRehab, with consideration given to the recommendations made by the surgeon.

  • Initially her rehab was more focused on increasing the elbow range, reducing the swelling as well as avoiding stiffness from developing in the shoulder. Within 2-3 months of treatment 90 degrees of range was achieved. Range was achieved by various techniques like manual therapy, hold-relax technique, soft tissue release and sustained stretch.
  • After 7 months of treatment with PhysioRehab, we not only achieved a functional range of 30-125 degrees, but also helped Ruchi to use her arm for daily activities.
  • After this, the treatment involved improving the strength of the muscles as well as constantly trying to get more and more range.


“I met with an accident on 22nd May 2017, which resulted in ‘closed fracture of Humerus distal 3rd left side’. I had to undergo a surgery and there was a plate inserted of around 6.5 inches just above my elbow.

I was in lot of pain for which I was given pain killers, but my elbow was stuck. It was not going beyond 90 degrees range of motion. After one month of my surgery I started with physiotherapy, but something was wrong since my elbow range, which was around 5-90 degrees, went down to 40-60 degrees. My arm was also swollen and stiff like a log.

I was referred to Dr. Anjana’s PhysioRehab by my Orthopedic surgeon. The day when I came to them I was put under Dr. Pooja’s care. In these 7 months with her patience and efforts I could more or less go back to my normal life. With her efforts and experience we have managed to achieve range between 30-125 degrees.

We have seen her dedication to see improvement of even few degrees on the measuring scale and in each session after every few exercises we use to measure the range to see the result of her efforts. I would like to thank her for being there, for her efforts, and for the patience she has kept throughout.

Thanks and Regards.”

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Category: Case Studies

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