Physical Therapy Department

Wrist Fracture

Fractures involving the wrist joint are quite common and the vast majorityof patients achieve good healing and recovery following their fracture.

This pamphlet is offered to help you achieve the best recovery possiblefollowing your fracture. It provides information to make you aware of andavoid the more common complications that can occur during the healing andrecovery process.

Pain: Pain following your injury is normal and your physician may offer youpain medication in the early phase of the healing process. Your pain shoulddecrease over time and your need for pain medication should subside. If yourpain does not decrease in a few days or if your pain worsens, you shouldinform your physician. Also inform your physician about change in color ornumbness or tingling in the fingers.

Swelling: Some swelling following your injury is normal and if you have hadsurgery, you may have greater swelling. Swelling should decrease with time.In cases of more severe swelling, it may take many months for swelling tocompletely resolve.

To reduce swelling, you will need to elevate your hand, massage yourfingers and hand, and exercise those joints that are not immobilized.

Elevation: Full-time elevation is essential for the first 48-72 hours followingyour injury or surgery. Full-time elevation may continue to be necessary ifsignificant swelling persists after the first 48-72 hours. Elevation during sleepand periods of elevation during the day may be necessary long into therecovery and rehabilitation process.

Elevation means hand above the elbow, elbow above the shoulder, andshoulder above the heart. It is best not to sleep on the injured side. If you havebeen given an arm sling, try not to use it for long periods of time. The slingdoes not fully elevate the hand and arm and prolonged use may lead toshoulder stiffness.

If you have any significant increase in your swelling, you should contactyour physician.

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2Suggestion for Elevation #1

Suggestion for Elevation #3

Suggestion for Elevation #2

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Massage: You can also decrease swelling by massaging the fingers andhand firmly from the tips of your fingers down toward your wrist. Imagine thatyou are trying to milk the swelling out of your fingers and hand back intoyour forearm and toward your heart. Massage each finger and thumb 20-30strokes, then the entire hand (if no cast). Use lotion.

Exercise: Exercise will be an essential component throughout your recov-ery and rehabilitation process. Initially, you will be exercising all the jointsthat are not immobilized following casting or surgery. The free joints of yourinjured side should maintain motion equal to your uninjured side.

Pain and Exercise: Joints with minimal swelling and normal mobility shouldbe essentially pain-free during exercise. Stiff joints and/or joints with morethan minimal swelling may be somewhat painful during exercise or for a shorttime after exercise. Working through this short-term pain will help youachieve better joint mobility and decrease swelling. However, if you haveincreasing pain at rest or increasing pain that wakes you from sleep, you maybe doing too much exercise or activity. If any increased pain or sleepdisturbance persists beyond approximately 24 hours, you should contactyour physician.

Physical Therapy: The majority of patients do well without formal physicaltherapy. However, in some cases, when there are more significant problemswith normal recovery, your physician may recommend physical therapy formore detailed instruction and guidance in a home rehabilitation program.

Pamphlet Diagrams: Where diagrams are provided, a left or right injuredextremity may be pictured. If your injury is to the opposite side, you will needto imagine a mirror image of what is shown.

ExercisesShoulder1. Move your arm forward and then overhead as high as possible. This

exercise may also be done while lying down and you may assist with yourother arm as needed.

2. Reach your injured arm over your good shoulder. With your good hand,gently pull your injured elbow toward your good side.

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3. Reach behind your head and down the middle of your back as far asyou can.

4. Reach behind your back and up the middle of your back as far as youcan.You may assist with your other arm as needed.

6If you cannot do exercises 3 and 4 because of metal hardware or a bent-elbow cast, then do exercise 5.

5. Lie down on your back. With your arm out to the side 90 and your elbowbent at 90, rotate your arm all the way back and then all the way forward.You may have a partner assist with this exercise by gently supporting thearm as you perform the movement

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Elbow1. Straighten and then bend the elbow as far as you can. Gently assist with

your other hand as shown.

Forearm1. When your cast and/or hardware is removed, place your healing arm by

your side with your elbow bent at 90; hold your arm steady with youruninjured arm; now turn your palm up toward the ceiling as far as you canand then turn your palm down toward the floor as far as you can.

8WristThe suggested starting position is with your elbow resting on a table, yourarm bent at the elbow and your uninjured hand supporting your forearm justbelow the wrist.

1. Bend your hand down at the wrist and then back at the wrist as far as youcan.

2. Bend your hand toward the thumb side as far as you can and then towardthe little finger side as far as you can.

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2. Do the duck bill, hook, straight, and full fist exercises as shown;start with your fingers straight and apart every time. Do not worry aboutthe position of your thumb during these exercises.

Fingers and Thumb1. Using your uninvolved hand, individually push each finger into a fully

bent position and then stretch each finger into a fully straightenedposition; slow and steady is better than fast and hard.

duck bill hook straight fist full fist

This diagramshows thegood righthand pushingthe leftfingers.

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3. Spread your straightened fingers apart as far as you can and thensqueeze them back together.

4. Make large circles in both directions with your thumb.5. Touch each finger tip with your thumb tip. You may assist with your

other hand.6. Bend your thumb as tightly into your palm as far as you can and then

move your thumb out away from your palm as far as you can. You mayassist with your other hand.

7. Squeeze a soft sponge or ball; progress as you can to a firmer spongeor ball. Try a few minutes every hour or two while you are awake.

Except for #7 above, exercises should be performed approximately 8-15repetitions each, 2-4 times a day. More or less exercise may be necessarydepending on your response to the exercise; follow the guidelines for painand exercise on page 3.

Additional Comments and Instructions

1994 KFH; KFHP, Inc.; TPMG, Inc.07758 (REV. 1-99) SPANISH 07758-1 CHINESE 07758-2