If you are someone who’s fallen and suffered a distal radius fracture and has had surgery, this is for you. My name is Hoang. I’m an occupational therapist and certified hand therapist, and I specialize in injuries of the hand and arm. And I see a lot of distal radius fractures.
What is a Distal Radius Fracture?
Distal radius fractures are frequently referred to as wrist fractures, however they actually involve this particular bone. Your distal radius is as shown. This bone in the middle is a long bone. Although it comes down here and is a portion of your wrist, the bone that makes up your elbow actually originates there.
You might see a scar like this down here if you shattered your distal radius after falling on an outstretched hand like this and required surgery. Sometimes there’s a little zigzag that you might have, but the majority of the time, if you have a distal radius fracture, you can have a scar that is right here.
And today, the majority of the time, they are repaired by the hand surgeon, orthopedic surgeon, using plates and screws. So, they put a plate there, and they capture all the little fragments and pieces of a fracture. After that, a hand and wrist treatment is really the only option.
Distal Radius Fractures: Common Question
One of the most common questions I get is, “How long does it take to rehab a distal radius fracture?” So, I’m gonna speak specifically from surgery because if you’ve had a fracture, but you didn’t need surgery or you opted not to have surgery, then that, like your rehab recovery might just look a little differently.
Does a Distal Radius Fracture require Surgery?
Surgery may be necessary for a distal radius fracture depending on a number of variables, including the degree of the fracture and the specifics of the patient. A shattered bone at the tip of the forearm, close to the wrist joint, is referred to as a distal radius fracture.
Distal radius fractures frequently do not require surgery, especially if they are stable and the fracture is not displaced, which means the ends of the shattered bones are still in the right place.
The decision regarding surgery will be made by an orthopedic specialist based on the specific characteristics of the fracture and the patient’s individual needs and health status.
So, if you’ve had surgery, then usually, that means that they have stabilized your fracture, meaning that they put all the pieces together, and they stabilize it with the plate and screws. Majority of the time, one of my favorite protocols that I like to follow…
Varied Protocols: Don’t Hesitate to Ask Questions:
And this might be different depending on your surgeon, so I would highly recommend asking your surgeon what kind of protocol they follow. And just asking them doesn’t mean it’s disrespectful. I encourage all my patients to know what’s going on with their injury. Ask those questions about what is the protocol they follow.
Is your doctor a very conservative doctor, or are they a little bit more up-to-date with some of the protocols and the research finding that says, “Hey, if you have a stable fracture, and you have a stable surgery, technically speaking, you’re allowed to move right away.” Some surgeons don’t want to, right? They’re like, “Even if I’ve had the surgery, I’m gonna cast that person.” It’s their preference. I don’t think there’s anything wrong with asking your surgeon, asking your therapist, what’s the protocol? What are you allowed to do? What are you not allowed to do? These are common questions.
As a certified hand therapist, I get these questions a lot because, you know, I’m located in Miami, and I am completely independent from surgeons, from hospitals, and I’m independent from doctors. So, I have my own opinions. And I see what’s worked and see what doesn’t work, over 20 years I’ve been doing this. So, I don’t think there’s anything wrong with asking questions. And I actually encourage it. And I think more people should ask questions.
Recovery Duration for Distal Radius Fractures:
Everyone comes in, they’ll ask me those questions: “Hoang, how long does it take to rehab?”
And this is exactly what I say. Well, technically speaking, once you are stabilized, you can actually come out of your post-op cast within five days.
So, one of the hand surgeons that I used to work with, this is what, him and I, we did all the time. He would send me his post-ops. Like by day five, I could take off the post-op dressing and I would make a splint, right? And then I would encourage them. “Okay, how do we take care of your wound? So, we know what to look for, how to ensure it’s closing, right. That there’s no risks and signs and symptoms of infections, right?” And then we would start moving right away.” So, if you were broken your wrist, that means you might not be able to move this part right away, but everything below and above it means that you’re allowed to move.
Initial Progress and Range of Motion:
So, one of the very first things we did was ensure that the fingers were moving right away. We made sure the thumb was moving, we made sure the shoulder was moving, we made sure the elbow was moving.
Between one and three weeks
So, by day five, we started to move, and we started to slowly progress. Two weeks, three weeks, we could start to do gentle active range of motion. You could turn your palm up and turn your palm down. So, this is pronation, turning your palm down. This is supination, turning your palm up. We would gently move. There’s a lot of ways in which you can gently move and not injure or do any damage to the bones because the surgery ensured that it was stable, right? And then by week four, you’re allowed to move even more, and by six weeks you’re allowed to move even more.
Between four and six weeks
So, between four and six weeks, that’s where you’re gonna see a majority of your clinical healing. Meaning, you probably, by now, go back to your doctor’s office, take X-rays. Sometimes, they take X-rays, sometimes, they don’t. Just based on seeing what they did and hearing about your symptoms, they can see, like, okay, you’re healing really well and we’re allowed to step it up and start to gently push on the broken wrist, right? Because it’s not broken, it’s healing now.
Recovery by eight weeks
And then by eight weeks, we’re allowed to do even more. We’re allowed to be even more aggressive. And what you want by eight weeks is to have full end range of motion for your wrist, for your fingers, for turning your palm up and palm down, and making sure you don’t have any shoulder problems. So, by eight weeks you’re allowed to fully move. You’re technically allowed to move to end range, do what’s called passive range of motion to get you to the end range. And by eight weeks, you’re allowed to start strengthening. Technically speaking, you can even start strengthening around six weeks.
Varying Definitions of Strengthening:
Strengthening means different things to different people. Doing strengthening with your hands is allowed at six weeks. You can start doing one pound, two pounds, three pounds at eight weeks. You just don’t wanna do really aggressive stuff, you know? Like if you’re a weightlifter, you’re gonna have to wait a little bit longer, right? But technically speaking, by 12 weeks, you should have full clinical healing and be allowed to do what’s called weight bearing. So, be able to push weight through your arms, right?
So, at eight weeks, when you’re getting out of bed and you put weight through it, it’s not a problem. You’re allowed to do that. If you’re getting out of the chair, you can push yourself and get yourself out of the chair.
Recovery at 12 week
At 12 week, you can put your full body weight on it, meaning technically speaking, if you’re able to, you can do a push-up. But it might be really challenging because you’re, by now, three months later, your whole arm has gotten a little weak. So, you’re gonna have to work yourself up to being able to put weight through it, being able to tolerate doing more than just one push-up. You know, incrementally improving it from being able to put weight on it for 30 seconds, one minute to doing 10 push-ups. So, it’s not like all the sudden, you can do it, but, like, incrementally over the three months, you’re going to do a little bit more, and a little bit more.
That is in a perfect world, right?
Technically speaking, how long does it take to rehab a distal radius fracture? Normal times are three months. I have seen people get so well by two months that they don’t really need any therapy. They can just slowly strengthen on their own. And I’ve seen people struggle six months later just trying to get end-range motion. And it’s because when you have an injury like this, there can be complications that slow your progress down.
But from a technical standpoint, it can take you as long as three months, normal average time, I would say:
“I’ve been doing this for over 20 years, and I have a very, like, small handful of people who have been so good that they were done before three months. The majority of the people take about three months. And then there’s a certain pocket of people who just have complications.”.
Variations in a distal radius fracture
You know, there’s variations in a distal radius fracture. It’s not like everyone who has a distal radius fracture has the same type of break, has the same type of healing time, are doing it at the same age, are going to the same surgeon. There’s so many different factors that, for you, I would encourage you to talk to your occupational therapist or certified hand therapist.
If you have a little bit more of a complex case, just ensure, make sure you’re going to someone who has some experience, such as a certified hand therapist, who is someone who specializes in treating hand and arm injuries, just like the one you have. So, seek them out. Ask as many questions as you need so that you can feel really comfortable to understand how long is it gonna take you because everyone is so different.
Miami’s Certified Hand Therapist for Distal Radius Fracture
If you’re in Miami and you have questions about your distal radius fracture and how long it’s gonna take you and what’s going on and why you’re not in that three-month technical protocol, you can certainly give us a call here at Hands on Therapy Services, and ask as many questions as you want.
If you live in another area, then really do find someone that you trust who you can ask questions to and get answers. I encourage all my patients to find a therapist that they trust. I get lots of questions because I also teach other therapists on how to become a certified hand therapist. So, when I create videos for hand therapy secrets, I have people who have injuries to just ask me questions, and I technically cannot give medical advice over social media. All I can do is be a voice to educate. And I really do encourage if you can’t get questions from one, you know, trust your gut, and be okay getting a second opinion to seeing what’s going on with your case, and how long it’s gonna take you and what are your complications.
Click here to watch our YouTube video on How Long Does it Take to Rehab a Distal Radius Fracture
About the author – an expert in physical & occupational therapy
Hoang Tran is a Miami certified hand therapist , the owner of Hands-on Therapy Services and the author of the book “The Hands-On Approach”. She loves helping people with hand, neck and shoulder problems because she knows how bad and debilitating they can get if not addressed and treated properly (once and for all!).
The aim of her occupational therapy practice is to bring patients back to full functionality, without pills, injections or surgery. Occupational and Physical Therapy are both offered at Hands-On Therapy by our experienced therapists who provide a comprehensive approach to your care.
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