Week 2 - Orthopedic Conditions

An OT is working with a client who recently sustained an orthopedic injury. During the acute stage, which intervention should be considered a priority?

Pain relief and reduction of swelling and inflammation

Before initiating treatment for a client recovering from an orthopedic injury, which factor is MOST important for the OT to consider?

Surgeon's protocol and stage of recovery

A client has difficulty performing dressing and bathing following an orthopedic injury. Which intervention BEST reflects the OT's primary treatment goal?

Restore occupational functioning through alternative methods, adaptive equipment, or environmental modifications

A client presents with a relatively undisplaced, stable closed upper-extremity fracture. Which management approach is best?

Protection alone without reduction or immobilization

A client has an unstable closed fracture in which the bone fragments cannot be approximated through closed manual reduction. Which procedure is most appropriate?

ORIF

A client with an upper-extremity fracture is 5 weeks post-injury. Which stage of healing is MOST likely occurring?

Union

An OT is treating a client in the early stages of shoulder fracture healing. Which intervention should the OT recognize as contraindicated?

Passive stretching

A client with a stable/minimally displaced shoulder fracture is 5 weeks post-injury. Which intervention is MOST consistent with the conservative management timeline?

Gentle submaximal isometrics

A client is 6 weeks post-injury from a stable/minimally displaced shoulder fracture. The client has decreased active movement but reduced acute pain. Which intervention should the OT anticipate beginning?

AROM in a gravity-lessened position

A client is 3 weeks post-op following shoulder fracture surgery. Which intervention is MOST appropriate?

Submaximal isometrics

A client is 6 weeks post-op following shoulder fracture surgery. Which intervention is listed for this stage?

AROM, with supine preferred over sitting

A client asks when they can begin weight bearing through the injured arm following shoulder fracture surgery. What should the OT communicate to the client?

Not for at least 6 months

An OT is treating a client following an elbow fracture. The medical team suspects Volkmann's ischemia. What should the OT recognize?

Compartment syndrome in the forearm requiring urgent medical attention

A client has a nondisplaced/minimally displaced supracondylar fracture. Which intervention is appropriate at 1–2 weeks?

Gentle AROM daily in a hinge splint

A client has a complex displaced supracondylar fracture treated with open reduction fixation. Which positioning is most appropriate?

90° elbow flexion

A client has difficulty with external rotation of the shoulder. Which rotator cuff muscles are primarily associated with this movement?

Infraspinatus and teres minor

A client reports shoulder pain associated with repetitive shoulder elevation above 90°. The OT suspects compression of structures in the subacromial space. Which condition is MOST consistent with this presentation?

Shoulder impingement syndrome

A client with shoulder impingement has thick and fibrotic bursa and tendons. Which stage is MOST consistent with this finding?

Stage II

An OT evaluates a client with shoulder pain. The client experiences pain during passive shoulder elevation but is pain-free during AROM and rotator cuff muscle testing. Which condition is MOST consistent with these findings?

Bursitis

A client with rotator cuff tendonitis reports pain with humeral movement above 90° but remains independent with ADLs. Which intervention is most appropriate?

Activity modification and strengthening

A client with a rotator cuff tear reports difficulty reaching objects on high shelves and demonstrates compensatory movement. Which intervention is MOST consistent with the overall treatment approach?

Regain ROM and strengthen the scapula and rotator cuff while addressing meaningful tasks

An OT is evaluating a client with a suspected nonoperative rotator cuff condition. Which area should be included in the evaluation?

Cervical ROM and sensory testing of C4–T1 dermatomes

An OT wants to understand how a client's shoulder condition affects everyday activities. Which approach is MOST appropriate?

Evaluate ADL function across low-, mid-, and high-range activities

A client with a nonoperative shoulder condition is experiencing pain. Which sleeping recommendation is best?

Avoid positioning the arm above shoulder level or in adduction and internal rotation

A client with a nonoperative rotator cuff condition has improving pain symptoms. Which progression is MOST appropriate?

PROM → AROM as pain decreases

A client is 7 weeks post-op following a rotator cuff repair. The surgeon's protocol permits progression. Which intervention is MOST appropriate?

Progression toward AROM

A client had a larger rotator cuff repair. Which change in the expected timeline should the OT anticipate?

AROM may not begin until 8–12 weeks post-op

An older adult sustains a hip fracture involving the femoral neck. Which treatment is considered as an option for some fractures involving the neck or head of the femur?

Hemiarthroplasty

An OT is evaluating a client after hip fracture surgery. Which information should the OT determine first during chart review?

Weight-bearing status and ROM restrictions

Mr. Brooks demonstrates difficulty with transfers, bed mobility, lower-body dressing, bathing, toileting, ambulation, and standing tolerance. Which intervention BEST reflects the OT approach presented in the case study?

Incorporate standing tolerance into functional ADLs, such as standing at the sink to brush teeth or standing to don pants