title: Nonoperative management of a patient with a two-part minimally displaced proximal humerus fracture: A case report.
abstract: Proximal humerus fractures account for up to 10% of all fractures; however, the literature lacks any detailed nonoperative management protocols or treatment progression guidelines that are based on large randomized controlled trials. Several studies support conservative treatment of minimally displaced fractures, yet they do not document the specific interventions used nor do they provide rationale for progression. This case report describes the conservative rehabilitation of a patient following a traumatic, minimally displaced, two-part proximal humerus fracture. The patient was a 58-year-old female who was referred to physical therapy 4 weeks following arm sling immobilization with the primary goal of returning to full-time employment as a retail associate. Outcome measures included the McGill Pain Questionnaire, a numeric pain rating scale, and goniometric range of motion. Upon discharge the patient had zero complaints of pain, improved range of motion, and increased strength, and she returned to her prior level of function. The interventions used along with rationale are described in detail. The plan of care for this patient may be used as a framework for further research to determine the true effectiveness of nonoperative treatment.
authors.affiliation: Illinois Masonic Medical Center, Chicago, Illinois 60657, USA. pwithrow@illinoisalumni.org
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Withrow
authors.forename: Judith L
authors.initials: JL
authors.lastname: Stoecker
authors.forename: Karen
authors.initials: K
authors.lastname: Stevens
authors.forename: Kelly
authors.initials: K
authors.lastname: Clark
mesh_terms: D000063:Accidents, Traffic; D000698:Analgesia; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008875:Middle Aged; D053580:Muscle Strength; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012149:Restraint, Physical; D012784:Shoulder Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020069:Shoulder Pain / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome