Occupational Therapy for Nonoperative Four-Part Proximal Humerus Fracture: A Case Report

Proximal humerus fractures are highly traumatic and debilitating. Surgical fixation may be contraindicated in older clients, thus requiring a systematic rehabilitation protocol. These clients may suffer loss of independence and require long-term assistance if not treated properly.

In this case report, we describe the occupation-based conservative rehabilitation of a retired male client after a four-part proximal humerus fracture. Outcome measurements used were the QuickDASH, the Numeric Rating Scale for Pain, goniometric measurements, and manual muscle testing. Repeated measures were used to collect data throughout a 12-mo period.

Scores and measurements demonstrated improvement in all four outcome measures with clinically notable improvements achieved and maintained throughout the 12-mo period. The client reported a full return to activity.

The techniques presented can be used by clinicians to create treatment plans, achievable functional goals, and realistic expectations for their clients. The protocol can aid clinicians in achieving objective milestones through occupation-based interventions.