Functional Rehabilitation After a Complex Subtrochanteric Frac-ture Treated with Locked Intramedullary Nail Osteosynthesis

Abstract

Complex subtrochanteric fracture represents a severe injury of the proximal femur, with a significant functional impact and complex postoperative rehabilitation requirements. This case report describes the clinical evolution of a 54-year-old female patient admitted following a skiing accident, in whom radiographic examination revealed a complex subtrochanteric fracture with traumatic detachment and displacement of the lesser trochanter by 30 mm relative to the femoral shaft, surgically treated by osteosynthesis with a locked intramedullary nail. Postoperatively, the patient presented with pain in the hip joint and a significant limitation of hip range of motion, resulting in impaired overall functional capacity. An individualized physiotherapy program was initiated, focusing on pain control, restoration of joint mobility, and recovery of muscle strength. Clinical evolution was assessed using functional scales, goniometric measurements, and muscle strength testing. Following the rehabilitation intervention, progressive improvement in hip joint mobility, increased range of motion, and enhanced muscle strength were observed, together with an improvement in the patient’s overall functional capacity. The results suggest the importance of a structured postoperative rehabilitation program in optimizing functional prognosis after complex subtrochanteric fractures.