Novel Physiotherapy Management and its Effects on Ulnar Styloid Process Fracture Recovery- A Case Report

Abstract

This case report details the physiotherapy management of a 60-year-old male who sustained a compound fracture of the left ulnar styloid process with injury to the flexor carpi ulnaris muscle following an accident involving a fodder-cutting machine. The emergency medical intervention included open reduction and external fixation. Upon referral for physiotherapy, the patient exhibited significant pain, reduced wrist mobility, and decreased muscle strength, with pain scoring 5/10 at rest and 8/10 during activity on the Numerical Pain Rating Scale (NPRS). Range of motion (ROM) testing revealed limited wrist flexion and extension on the affected side (30º and 20º, respectively). At the same time, muscle strength was notably diminished, with the wrist flexors and extensors graded 2/5 on Manual Muscle Testing (MMT). The physiotherapy regimen was structured in phases: acute (cryotherapy, immobilization), subacute (active-assisted ROM, tendon mobility), rehabilitation (progressive ROM and light weight-bearing), and strengthening (resisted exercises). The aim was to restore wrist strength and mobility while preventing stiffness. Surgical intervention and subsequent therapy were effective, as follow up X-rays confirmed the successful union. This case highlights the importance of a structured, phased approach to rehabilitative care for complex upper extremity fractures.