Fractures involving the wrist joint are quite common and the vast majority

of patients achieve good healing and recovery following their fracture.

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

Physical Therapy Department

Wrist Fracture

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

Swelling: Some swelling following your injury is normal and if you have had
surgery, you may have greater swelling. Swelling should decrease with time.
In cases of more severe swelling, it may take many months for swelling to
completely resolve.
To reduce swelling, you will need to elevate your hand, massage your
fingers and hand, and exercise those joints that are not immobilized.

Elevation: Full-time elevation is essential for the first 48-72 hours following
your injury or surgery. Full-time elevation may continue to be necessary if
significant swelling persists after the first 48-72 hours. Elevation during sleep
and periods of elevation during the day may be necessary long into the
recovery and rehabilitation process.
Elevation means hand above the elbow, elbow above the shoulder, and
shoulder above the heart. It is best not to sleep on the injured side. If you have
been given an arm sling, try not to use it for long periods of time. The sling
does not fully elevate the hand and arm and prolonged use may lead to
shoulder stiffness.
If you have any significant increase in your swelling, you should contact
your physician.

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

Exercise: Exercise will be an essential component throughout your recovery and rehabilitation process. Initially, you will be exercising all the joints
that are not immobilized following casting or surgery. The free joints of your
injured side should maintain motion equal to your uninjured side.
Suggestion for Elevation #1

Pain and Exercise: Joints with minimal swelling and normal mobility should
be essentially pain-free during exercise. Stiff joints and/or joints with more
than minimal swelling may be somewhat painful during exercise or for a short
time after exercise. Working through this short-term pain will help you
achieve better joint mobility and decrease swelling. However, if you have
increasing pain at rest or increasing pain that wakes you from sleep, you may
be doing too much exercise or activity. If any increased pain or sleep
disturbance persists beyond approximately 24 hours, you should contact
your physician.
Physical Therapy: The majority of patients do well without formal physical
therapy. However, in some cases, when there are more significant problems
with normal recovery, your physician may recommend physical therapy for
more detailed instruction and guidance in a home rehabilitation program.
Suggestion for Elevation #2

Pamphlet Diagrams: Where diagrams are provided, a left or right injured

extremity may be pictured. If your injury is to the opposite side, you will need
to imagine a mirror image of what is shown.

Suggestion for Elevation #3

Exercises

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

Shoulder
1. 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 your
other 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.

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

If you cannot do exercises 3 and 4 because of metal hardware or a bentelbow cast, then do exercise 5.
5. Lie down on your back. With your arm out to the side 90 and your elbow
bent 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 the
arm as you perform the movement

Elbow
1. Straighten and then bend the elbow as far as you can. Gently assist with
your other hand as shown.

Forearm
1. 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 your
uninjured arm; now turn your palm up toward the ceiling as far as you can
and then turn your palm down toward the floor as far as you can.

Wrist

Fingers and Thumb

The suggested starting position is with your elbow resting on a table, your
arm bent at the elbow and your uninjured hand supporting your forearm just
below the wrist.

1. Using your uninvolved hand, individually push each finger into a fully
bent position and then stretch each finger into a fully straightened
position; slow and steady is better than fast and hard.

1. Bend your hand down at the wrist and then back at the wrist as far as you
can.
This diagram
shows the
good right
hand pushing
the left
fingers.

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

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 about
the position of your thumb during these exercises.

duck bill

hook

straight fist

full fist

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

Additional Comments and Instructions

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 may
assist with your other hand.
7. Squeeze a soft sponge or ball; progress as you can to a firmer sponge
or ball. Try a few minutes every hour or two while you are awake.

Except for #7 above, exercises should be performed approximately 8-15

repetitions each, 2-4 times a day. More or less exercise may be necessary
depending on your response to the exercise; follow the guidelines for pain
and exercise on page 3.

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07758 (REV. 1-99) SPANISH 07758-1 CHINESE 07758-2

1994 KFH; KFHP, Inc.; TPMG, Inc.