- The patient is a 14-year-old male who injured his right index finger during a kabaddi match. He underwent surgery for an avulsion fracture but developed stiffness after one month.
- On examination, the patient had tenderness and edema around the index finger MCP joint with limited range of motion and muscle weakness.
- The diagnosis was post-traumatic stiffness. Physiotherapy management included scar tissue massage, joint mobilization, and exercises over 3 weeks to improve range of motion and strength. Follow-up showed significant improvement in all areas.
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POST OPERATIVE INDEX FINGER STIFFNESS CASE
1. POST OPERATIVE INDEX FINGER
STIFFNESS
CASE PRESENTATION
Presented by:
Dr. Priya Maurya
MPT (Sports Physiotherapy)
2. Demographic details
Name:- Lucky
Age:- 14year
Gender:- Male
Dominance:- Right handed
Occupation:- Student
Address:- Defence School, Kalpi
Date of assessment:- 28th September 2021
4. History of present illness:
• On 26th August 2021 while playing a kabaddi match player got injured
in the hand, about which he came to know after the match, following
which he immediately visited MMSH emergency, where he was
primarily treated with analgesics and was straight away taken for an
X-ray, which revealed avulsion fracture in the index finger for which
he went under a surgical procedure??? on the same day
• On 28th September 2021, which is approximately after one month
after the surgery, patient visited the Physiotherapy department of
Maharishi Markandeshwar University, MM (DU) with the complaint of
not able to make fist, write and unable to lift heavy objects
5. Pain history
• Side:- Right
• Site:- Index Finger
• Onset:- Gradual
• Duration:- Felt during activity
• Type:- Non Radiating
• Aggravating factors:- During movement
• Relieving factors:- During hot water fomentation
• Intensity:- 4/10 NPRS
6. History of past illness
• Patient had no similar kind of event or injury reported in the past
Medical History
• Not relevant
Pharmacological History
• Patient had taken analgesics in initial 10 days of surgery
Surgical History
• None
7. Personal History
• No history of drug abuse and alcohol intake
Family History
• Not relevant
Socio-economic History
• According to Modified Kuppuswamy Socio-economic Scale (MKSS),
score is 12 which belongs to lower middle socio-economic class
9. On Palpation:
• Tenderness: Grade 1 (around the metacarpophalangeal joint of the
index finger)
• Edema : Present (around the metacarpophalangeal joint of the index
finger)
10. On Examination
Motor:
Range of Motion: (Left)
Metacarpophalangeal Joint Range of motion Endfeel
Flexion 0- 60 degree Empty
Extension 0-30 degree Empty
Abduction 0-20 degree Empty
Adduction 20-0 degree Empty
18. Problem list
• Adhesion due to scar
• Pain around the metacarpophalangeal joint of the index finger
• Limitation in movements around the joint
• Decreased muscle strength
20. Physiotherapy Management
Week 1:
• Hydrocollator pack- 15 min (around MCP joint)
• Soft tissue release near the scar area on dorsal, as well as
palmar aspect
• MCP joint Maitland mobilization ( anterior posterior glide)- 30
glides, 2 sets (Grade 1)
• MCP mobility exercises (within available ROM)
Samdrala S et. al. Outcome of active mobilization after tendon repair: A study in a tertiary care centre .
IJOS 2020;6(3):242-246
21. Week 2:
• Hydrocollator pack- 15 min
• Soft tissue release
• Hold relax technique to improve range
• MCP joint mobilization (anterior glide)- 30 glides, 3 set
(grade 3)
• MCP joint mobilization (posterior glide)- 30 glides, 3 set
(grade 3)
• MCP joint mobilization (transverse glide)- 30 glides, 3 set
(grade 3)