Reabilitação de paciente com fratura proximal de úmero fixada com placa de ângulo-fixo

Resumo (EN)

Objective – Proximal humerus fractures are common injuries that lead the patients to severe functional restrictions and complications. This case report describes the rehabilitation process of a patient presenting with a proximal fracture on the left humerus (Neer 4-part), who was subjected to open reduction with internal fixation (ORIF) with a fixed-angle plate fixation of the proximal humerus. Methods – The twelve-week physiotherapeutic intervention started on the 1stpostoperative day, while the patient was still at the hospital, and comprised daily sessions during the hospitalization period. After clinical stabilization and hospital discharge, the patient was referred for treatment at the Outpatient Physiotherapeutic Service (twice a week) and was followed up to the 12th postoperative week (clinical re-examination and evaluation using the Constant questionnaire and DASH index). The patient was re-evaluated 24 weeks postoperatively. Results – At the end of the 12thpostoperative week, the patient exhibited satisfactory results to both clinical and functional assessments after treatment protocol and was considered rehabilitated. The arch of movement on the affected limb was functionally rehabilitated and muscular strength was reestablished. The patient scored 75 points in the Constant questionnaire and DASH index was 12.5. After the 24thpostoperative week, the patient scored 79 in the Constant questionnaire and DASH index was 8.3. Conclusion – The treatment protocol involving ORIF with fixed-angle plate fixation of the proximal humerus on a patient diagnosed with a fracture (4-part Neer) was deemed effective and provided a satisfactory functional gain.