What is a distal radius (wrist) fracture?

The wrist joint is made up of two long bones, your ulna and radius, and a group of smaller bones called the carpal bones.

The distal end of the radius is the end nearest your wrist. This is commonly broken when you fall with your hand outstretched in front of you. Sometimes this is accompanied by a small break at the end of the ulna also.

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Conservative management of distal radius fractures

When you attend A&E, an X-ray will be done to diagnose your fracture and assess the position of the bones.

If your fracture is uncomplicated then it will be managed conservatively (without an operation).

Sometimes the doctors in A&E may manipulate your bones to improve the position.

You will then be placed in a cast or splint to reduce your pain, stabilise the bones and allow them to start healing.

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Operative management of distal radius fractures

If your fracture is more complicated, the orthopaedic doctors may recommend an operation where they use metalwork to fix your broken bones in a good position to help them heal.

During the operation you will be placed in a cast or splint.

You can also follow the exercises in this booklet. If you are unsure, you can ask your surgeon for advice at your follow-up appointments.

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Common problems / things to look out for

• If you are in a cast and it becomes tight and uncomfortable, or is stopping your fingers moving, please attend fracture clinic.

• If you develop any colour change, pins and needles, or numbness in your hand or fingers, it is important to seek medical advice immediately.

What to do and expect

Early stage (0–6 weeks)

• You will usually be in your cast or splint for 4–6 weeks.

• If you are in a splint, it is important to wear this day and night, only removing it for hygiene purposes and to complete exercises if advised by your doctor or physiotherapist.

• During this early stage it is important to control swelling and maintain movement in your hand, elbow, shoulder and neck.

Swelling control

Try to elevate your hand above your heart as much as possible and regularly move your fingers into and out of a fist.

Wound care / Scar management

If you have had an operation, you will be seen either by myself or a nurse in clinic about two weeks after your operation. At this appointment the surgical wound will be checked and any stitches removed.

If you notice your surgical wound looking red, feeling hot or oozing at all, it is important to get it checked by a medical professional.

Once the wound is well healed you will be able to start caring for your scar.

It is advised to complete regular scar massage. Apply firm pressure in a circular motion to your scar and the surrounding skin for a couple of minutes, a few times a day. You can use any non-perfumed moisturiser to help with this.

If your scar feels very sensitive, exposing it to different textures can help — for example a rough towel or a silky piece of clothing.

Exercises to stop your hand, elbow, shoulder and neck getting stiff

Complete these exercises little and often, throughout the day.

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Scapular setting - Squeeze your shoulder blades together.

 

Shoulder flexion - With your arm straight, lift it up and overhead.

 

Elbow flexion and extension - Fully bend and straighten your elbow.

    

Elbow pronation and supination - Keep your elbow tucked into your side and turn your palm up and down.

    

Finger flexion and extension - Make your fingers into a fist and then stretch them out.

    

Finger dexterity - Practise touching each finger to your thumb.

    

Mid stage (6–12 weeks)

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By this stage your bones should be healed enough to start getting the wrist moving and gradually rebuilding the strength in your wrist. During this stage it is important to regain a reasonable range of motion in your wrist. Once this is achieved, you can start strengthening and weight-bearing through the wrist.

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Exercises to regain movement in your wrist

Aim to do these three times per day, every day.

Active range of movement — wrist flexion and extension

Bend your wrist forwards and backwards as far as comfortable.

   

Active range of motion — ulnar and radial deviation

Rest your palm on a table and try to slide your hand side to side.

    

Passive stretches — flexion and extension

Bring your hands into the position shown until you feel a stretch. Hold for 30–50 seconds, 3 times per day.

    

Proprioception (retraining your sense of where the joint is in space)

Roll an object under your hand. Practise for 30 seconds, 3 to 5 times.

 

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