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Patient Information

Name: _________________ Date of Injury: //____ Type of Fracture: _________________ Treating Physician: _________________

Daily Progress Tracking

Pain Level (0-10 Scale)

Date	Morning	Afternoon	Evening	Notes

Swelling Measurement

Measure around the injured area using a soft measuring tape

Date	Measurement (cm)	Compared to Uninjured Side

Range of Motion Progress

Mark progress with checkmarks (✓)

□ Can wiggle toes/fingers □ Can perform gentle exercises as prescribed □ Can achieve 25% normal range □ Can achieve 50% normal range □ Can achieve 75% normal range □ Full range of motion restored

Weight-Bearing Status (if applicable)

□ Non-weight bearing □ Toe-touch weight bearing □ Partial weight bearing □ Weight bearing as tolerated □ Full weight bearing

Physical Therapy Exercises

Exercise	Sets	Repetitions	Completed

Red Flags to Report

Severe pain that worsens
Numbness or tingling
Skin color changes
Fever
Inability to move digits

Follow-up Appointments

Date	Time	Provider

Please bring this chart to all follow-up appointments

Fracture Recovery Progress Tracking Chart

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