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Case Study

AF | Polytrauma | Intensive Neurotherapy Centre

35 year old male presented to Hobbs Rehabilitation following a polytrauma from a road traffic accident. Injuries include right open tibia and fibula fractures, currently being managed long term in a ilizarov frame. Left tibial plateau and metatarsal fractures. C7 fracture and left parietal and occipital brain contusions. Left shoulder fracture dislocation, axillary artery damage and brachial plexus injury.

Main Areas Affected

• Left upper limb weakness from brachial plexus injury
• Reduced ROM left upper limb and right lower limb
• Reduced mobility as a result of right ilizarov frame
• Cognitive and physical fatigue

Functional Ability on Admission

• Transferring with a crutch and tip-toe, step to gait on right
• Using wheelchair for mobility around the house/long distances
• Unable to manage stairs at home
• Unable to use left upper limb to support with activities of daily living
• Poor sleep hygiene and lack of routine

Hobbs Rehabilitation Input

• Outpatient Physiotherapy and Occupational Therapy
• 6 hours a week over 3 days
• Ongoing since April ‘23

Functional Ability on Discharge

• Mobilising with 1 x crutch 10-20 metres with improved heel contact
• Able to complete kitchen tasks in standing and involving left arm
• Able to independently go up and down stairs using a crutch or rail
• Working towards incorporating fatigue management techniques into routine


10m Walk Test
28.4% Improvement
Modified Fatigue Impairment Scale
31% Improvement
Timed Up and Go
17% Improvement


To be able to mobilise 10m using 1x crutch
To be able to make a cup of coffee in standing in the kitchen, involving the left upper limb
To be able to go up and down stairs in order to return to sleeping upstairs and access his holiday caravan


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