Physical therapy evaluation and treatment of a 59-year-old female with open reduction and internal fixation of left femoral neck fracture with osteoporosis: case report

Background and Purpose: This case report presents evidence-based physical therapy assessments and interventions for a patient with open reduction internal fixation of left hip fracture with osteoporosis. The case demonstrates the importance of reassessment and outcome measures to help determine whether the plan of care requires change due to the patient’s complication or continues as originally planned initially. Case Description: The patient is a 59-year-old female with symptoms of pain, decreased range of motion, muscular strength, balance issue, and endurance of left lower extremity. The examination and treatment were focused on building strength, increase range of motion, and improve endurance which limits normal functional mobility and increases pain. Outcomes: The outcome measure demonstrates the patient’s pain is well under control. The patient’s lower extremity strength and risk of fall remain relatively the same base on the 30-second sit-to-stand and timed up and go tests, but she was able to perform the tests with better form compare to the initial exam. However, she rated her LEFS at 50% of max function, which showed the patient’s low confidence and fears performing daily activities. Discussion: Although the patient did not reach the goals according to the protocol, the physical therapists and patient’s primary physician believe she is progressing at a fair pace at her first 6 months follow up after post-op after her 6th therapy session. This is mainly due to the patient’s health complications and her ability before the accident. Several limitations can be addressed to improve the validity of the case report