Broken Wrist

john miller physiotherapist

Article by John Miller

Fractured Wrist

broken wrist

Common wrist fractures include:

  • Fractured Radius (see image)
  • Fractured Ulna
  • Colles Fracture (# Radius + # Ulna) 
  • Fractured Carpals
    • Scaphoid Fracture (most common)
    • Lunate Fracture / Kienbock Disease
    • Capitate Fracture
    • Trapezium Fracture
    • Trapezoid Fracture
    • Triquetrum Fracture
    • Hamate Fracture
    • Pisiform Fracture

Each wrist fracture (broken wrist) needs specific rehabilitation based on injury type and fracture stability. Unstable fractures will almost always require surgical stabilisation. Stable fractures will be treated with a protective and supportive splint and monitored for appropriate fracture healing. If they show signs of instability, then your surgeon may consider operative stabilisation.

Based on that, it is very important to only perform the exercises prescribed by your Orthopaedic Surgeon or Physiotherapist. You should also wear your wrist splint/cast at all times unless advised otherwise by your physiotherapist or surgeon. 

6 Weeks Post-Fracture General Guidelines

  • Splint/Cast. Do NOT remove the splint or bandage unless instructed.
  • No movement of the wrist. No AROM, PROM or Strengthening.
  • Physiotherapy for the wrist will commence once your fracture is stable and the cast is removed. Your surgeon will advise.
  • Restrictions: No lifting, pulling, pushing or weight bearing for 6 weeks.
  • No driving for 6 weeks. You are not insured!
  • You may type, write and feed yourself with a lightly loaded fork.
  • No sports or activities where you are at risk of falling onto your wrist.
  • You will begin active (AROM) and passive (PROM) of the fingers to prevent stiffness, reduce swelling and avoid Chronic Regional Pain Syndrome (CRPS). Move your elbow and fingers through their full range of motion 10x/hour. These must be performed in the splint.
  • Vitamin C reduces the prevalence of CRPS after wrist fractures. A daily dose of 500 mg for fifty days is recommended. (Aïm et al 2017)
  • Your surgeon may re-Xray weekly to ensure that the fracture is healing correctly. In some cases, they may recommend surgery to stabilise the fracture if it is not healing appropriately.

Hand Swelling, Pain or Pins & Needles

Important

Each radius fracture (broken wrist) needs specific rehabilitation based on the injury type and fracture stability. Unstable fractures will almost always require surgical stabilisation. Stable fractures will be treated with a protective and supportive splint and monitored for appropriate fracture healing. If they show signs if instability, then your surgeon may consider operative stabilisation.

General Advice: First 6-Weeks Post-Fracture

The follwoing advice is general. Please seek to advice of your trusted helatcare professional.

  • Splint/Cast. Do NOT remove the splint or bandage unless instructed.
  • No movement of the wrist. No AROM, PROM or Strengthening.
  • Physiotherapy for the wrist will commence once your fracture is stable and the cast is removed. Your surgeon will advise.
  • Restrictions: No lifting, pulling, pushing or weight bearing for 6 weeks.
  • No driving for 6 weeks. You are not insured!
  • You may type, write and feed yourself with lightly loaded fork.
  • No sports or activities where you are at risk of falling onto your wrist.
  • You will begin active (AROM) and passive (PROM) of the fingers to prevent stiffness, reduce swelling and avoid Chronic Regional Pain Syndrome (CRPS). Move your elbow and fingers through their full range of motion 10x/hour. These must be performed in the splint.
  • Vitamin C reduces the prevalence of CRPS after wrist fractures. A daily dose of 500 mg for fifty days is recommended. (Aïm et al 2017)
  • Your surgeon may re-Xray weekly to ensure that the fracture is healing correctly. In some cases, they may recommend surgery to stabilise the fracture if it is not healing appropriately.

Beware of CRPS (Chronic Regional Pain Syndrome)

Hand Swelling, Pain or Pins & Needles

It is extremely important to prevent hand and finger swelling post-fracture. Near permanent elevation (high arm sling) and regular finger and upper arm movement while protecting the fracture is the key. CRPS is a very significant and painful complication that can complicate your rehabilitation. Carpal tunnel syndrome which may present as pins and needles to your hand. Please report any increase in swelling, pins and needles, or pain to your physiotherapist or doctor ASAP.

It is extremely important to prevent hand and finger swelling post-fracture. Near permanent elevation (high arm sling) and regular finger and upper arm movement while protecting the fracture is the key. CRPS is a very significant and painful complication that can complicate your rehabilitation. Carpal tunnel syndrome which may present as pins and needles to your hand. Please report any increase in swelling, pins and needles, or pain to your physiotherapist or doctor ASAP.

Post-Fracture Exercises

Post-fracture exercises are specific to your fracture and should be performed after assessment and guidance from your healthcare professional. Based on that, it is very important to only perform the exercises prescribed by your Orthopaedic Surgeon or Physiotherapist. You should also wear your wrist split/cast at all times unless advised otherwise by your physiotherapist or surgeon.

Do your exercises on a frequent basis throughout the day. Multiple sessions of short duration are generally better than longer sessions done only once or twice. 

For more specific advice please consult your physiotherapist or doctor.

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Broken Wrist Treatment Options

  • Early Injury Treatment
  • Avoid the HARM Factors
  • Soft Tissue Injury? What are the Healing Phases?
  • What to do after a Muscle Strain or Ligament Sprain?
  • Acupuncture and Dry Needling
  • Sub-Acute Soft Tissue Injury Treatment
  • Scapular Stabilisation Exercises
  • Biomechanical Analysis
  • Proprioception & Balance Exercises
  • Medications?
  • Soft Tissue Massage
  • Brace or Support
  • Dry Needling
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Joint Mobilisation Techniques
  • Kinesiology Tape
  • Neurodynamics
  • Physiotherapy Instrument Mobilisation (PIM)
  • Prehabilitation
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • Yoga
  • Broken Wrist FAQs

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • When Should Diagnostic Tests Be Performed?
  • Can Kinesiology Taping Reduce Your Swelling and Bruising?
  • Heat Packs. Why does heat feel so good?
  • How Much Treatment Will You Need?
  • What are the Common Massage Therapy Techniques?
  • What are the Early Warning Signs of an Injury?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What is the Correct Way to Sit?
  • What's the Benefit of Stretching Exercises?
  • When Can You Return to Sport?
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker
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    Other Sources of Arm Pain



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    Last updated 20-Feb-2019 04:21 PM

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