Which is the BEST course of occupational therapy for a nondisplaced humeral neck fracture?

• A. Instruct the client in use of a sling with no ROM for 3 weeks
• B. Instruct the client in use of a sling with supervised ROM
• C. Provide no occupational therapy intervention because the client will have a surgical reduction
• D. Fabricate a removable orthosis

Answer: (B)

Balancing protection of the healing bone with preservation of shoulder mobility is essential. For a nondisplaced humeral neck fracture, you don’t want to keep the joint completely still for an extended period, because that raises the risk of stiffness and loss of ROM. The best occupational therapy approach is to use a sling to protect the arm while initiating supervised range of motion early. This means the therapist guides gentle movements within a safe range, monitors pain and signs of displacement, and progresses to active-assisted and then active ROM as healing permits. The goal is to maintain joint mobility and function while still protecting the fracture site.

Immobilizing with no ROM for weeks is too rigid and increases stiffness and muscle atrophy, so it’s not ideal. The idea of no OT intervention because surgery is expected isn’t fitting here, since nonoperative management is common for nondisplaced fractures and OT still plays a crucial role in ROM and functional recovery. Simply fabricating a removable orthosis misses the benefit of structured, supervised ROM within a protective plan.