Table 3. The structured physiotherapy protocol for the given case.

PROM: Passive range of motion

	Goals of rehabilitation	Therapeutic intervention	Rehabilitation rationale
1	Patient Education	Educate the patient about the condition prevention of bedsores and the importance of exercise	Changing the position of the patient every two hours
2	Reduce swelling	Applying a Crepe bandage in the figure of four pattern from knee to hip and elevating the leg at 150  with the knee extended, the knee and foot will be supported by a pillow	To reduce swelling by compression and elevation
3	Correction of limb length discrepancy	Suitable Shoe modification with a height of 4 cm in such a way both limb lengths will be the same	To reduce or prevent  limb length discrepancy
4	Prevent complications of the pulmonary and cardiovascular system	Initially, an active cycle of breathing technique for 10 repetitions as the condition progresses thoracic expansion exercises and spirometry started (10 repetitions of each two hourly)	To maintain and improve lung compliance
		Upper limb mobility exercises, Cycle ergometer (two times a day)	To prevent cardiovascular complications and improve endurance
5	To maintain the hip and knee joints' Range of motion	PROM exercise for Hip and knee in supine lying to the non-fracture side. 15 days – 20 repetitions x 3 sets. Progression: 30 repetition x 3 sets	flexion-extension of knee, flexion-extension, adduction-abduction and extension of hip (20 repetitions x 3 sets)
		PROM exercise of knee and Hip in supine lying on the affected side	Ankle dorsiflexion 20o Ankle plantarflexion 15o
6	To maintain the strength of the upper extremities	(1) Shoulder and elbow flexion-extension, shoulder adduction-abduction with 1kg weight cuff	Increasing the weight as strength progress help with ambulation or further rehab (10 repetitions x 3 sets each)
		(2) Holding the dumbbells for five seconds without support
7	To activation of muscles	Functional electrical stimulation	Quadriceps, Hamstring, and calf muscles (30 reps x 3 sets)
8	Roods approach	Facilitatory technique	–To improve the tone of muscles from a flaccid state. – fast brushing Icing, stroking,   tapping, quick stretch
9	Proprioceptive neuromuscular facilitation	Proprioceptive neuromuscular facilitation:  (1) strengthening  (2) stretching	Proprioceptive Neuromuscular Facilitation to the lower limb bilaterally which improve mobility stability  and strengthen lower limb musculature (10 reps x 3 sets)