REGENERATIVE REHABILITATION MEDICINE IN A LATERAL MALLEUS FRACTURE IN AN ELDERLY PATIENT: CASE REPORT

Indroduction: A fracture as a consequence of a fall is not unusual in medicine practice in the frailty elderly people and it is strongly connected with a negative impact in the patient’s Quality of life and medical. We are presenting the influence of Extracorporal Shockwave Therapy (ESWT) in combination with high Peripheral Pulsed Magnetic Stimulation and PhotoBioModulation (PBM) with High energy Laser in female patient, 84 years old, able to walk independently, who suffered from a lateral malleus fracture after a referred fall. Patient had a medical record with Diabetes mellitus type II. In the initial medical evaluation patient suffered from severe pain (VAS: 8/10) and was barely walking with the aid of two crutches and an ankle foot orthosis. Material - Method: Rehabilitation program with ESWT in combination with peripheral Pulsed Magnetic Stimulation, PBM (High energy Laser) and therapeutic exercise. ESWT parameters consisted of frequency 20Hz, 4000 shocks per session, 4 bars pressure intensity and energy flux density 0.5 J/mm2. Peripheral Pulsed Magnetic Stimulation parameters were frequency 5Hz, session’s duration minutes and magnetic field’s intensity 40% of 3 Tesla. PBM parameters were frequency 2Hz, average power 8W, and total energy delivered per session 4080J. Sessions rhythm were twice per week and 8 (eight) sessions in total for the peripheral pulsed magnetic stimulation and the photobiomodulation while 1 (one) every ten days and 3 (three) in total for the ESWT. Results: Outcome scales were the Visual Analogue scale for pain evaluation (VAS: 1/10 versus VAS:8/10 ), X-Ray obvious improvement 4 (four) weeks after fracture and the immediate elderly patient’s mobility maintenance with improvement of her gait pattern as she was walking with a cane and an ankle foot orthosis (Aircast) 1 (one) post injury month. Conclusion: The combination of Extracorporal Shockwave Therapy with peripheral Pulsed Magnetic Stimulation and Photobiomodulation in the Regenerative Rehabilitation Medicine field reflects their positive influence in boosting bone regenerative process during the fracture healing management and they could be considered as first line treatments. These treatments are well tolerated from patient, short in time, without any side effects, they reduce significantly the medical costs and improve elderly’s patients Quality of life with theirs immediate mobilization.