AJOT CE: Occupational Therapy for Nonoperative Four-Part Proximal Humerus Fracture: A Case Report
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Publisher: AOTA Continuing Education

Published: 2018

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Non-Member Price: $24.99

Product Overview

Earn CE Credit With AJOT Articles!

Learn about tested treatment strategies by reading AJOT articles in your area of practice. Become an evidence-based practitioner and demonstrate your knowledge by passing the course exam.  Articles have been selected for their relevance to practice, fresh ideas, and strong evidence supporting treatment and the distinct value of OT.


Earn .1 AOTA CEU (1.25 NBCOT PDU/1 contact hour)



OBJECTIVE. 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.


METHOD. 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.


RESULTS. 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.


CONCLUSION. 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.



William P. Finley, MS, OTR/L, CSCS, CHT, is Senior Clinical Instructor, Department of Rehabilitation Medicine, NYU Langone Medical Center, New York, and Lead Instructor, Gold Standard Seminars LLC, New York;


Steve Van Lew, MS, OTR/L, is Director, Department of Rehabilitation Medicine, NYU Langone Medical Center, New York.


Learning Objectives:

1.     List characteristics of a four-part proximal humerus fracture diagnosis and discuss effects of this condition on occupational performance

2.     Based on the evidence, discuss nonoperative management of four-part proximal humerus fractures for adults with this condition

3.     Explain the use of the occupation-based rehabilitation protocol with clients who have a nonoperative four-part proximal humerus fracture


CE Find Key Words: occupation based intervention, humeral fracture, orthopedics, hand rehabilitation


Learning Level: Advanced


Target Audience: Occupational Therapists and Occupational Therapy Assistants


Content Focus: Category 1: Domain of OT; Category 2: OT Process: Intervention


Reference Information:

Finley, W. P., & Van Lew, S. (2018). Case Report—Occupational therapy for nonoperative four-part proximal humerus fracture: A case report. American Journal of Occupational Therapy, 72, 7203210010. https://doi.org/10.5014/ajot.2018.026963