A wrist fracture is a break of one or both of the bones in your forearm near your wrist joint. A wrist fracture is sometimes known as a 'distal radius fracture'.
Many wrist fractures happen to people when they fall with their hand streatched out. Sometimes the fracture is just a small crack in the bone, however, the fracture can be more severe with the bone broken in many places and damage to the surface of your wrist joint.
It is normal for there to be swelling, stiffness, weakness and pain following cast removal. It takes around twelve weeks for bone and soft tissue to heal but the above symptoms can persist long after the healing period.
The rehabilitation of best possible movement, strength and function, and the reduction of pain, can take many months. If you have fallen, it can also take time to regain your confidence. Everyone’s recovery journey is different.
Following cast removal, most people will experience an increase in pain as they start to move their joints. This is normal.
Taking pain medication is recommended if pain is limiting your ability to sleep, exercise or undertake daily activities. Follow the instructions from a prescribing clinician, pharmacist or the information provided with over the counter medications such as paracetamol or ibuprofen.
Talk to a doctor or pharmacist if you are unsure about which pain medication is right for you, particularly if you have other medical conditions and/or take other medication.
- Early exercise is vital to improve movement, strength and function.
- Working within an acceptable level of pain to you, attempt these exercises at least 3x daily.
- It is suggested that you slowly repeat the exercises 5-10 times each or until movement eases.
- Exercising in warm water is generally easier as heat eases stiffness and water eliminates gravity from the hand and wrist making the exercises more comfortable, as follows:
- Fill a large bucket with warm (not hot) water
- Put your hand and forearm into the water covering as much of the forearm as possible
- Open and close your fist
- Touch your thumb to all finger tips
- Span and close fingers
- Make a loose fist and use your knuckles to make small circles on the bottom of the bucket keeping your shoulder and elbow still
- Gradually make the circles larger and change direction regularly
- Draw some of, or the entire alphabet – vary the size of letter
- Make brush strokes on the bottom of the bucket – up and down and side to side
- Move your hand to all points of the compass on the bottom of the bucket with the forearm in a fixed position
- When ready, try squeezing a sponge.
Do not use water if you still have open wounds after fracture plating or pinning.
These exercises can be done without water.
In addition to doing regular wrist and hand exercises, you will also need to begin to use your hand to do daily activities. Normal use of the hand is an essential part of effective rehabilitation, for example:
- Grasp and use cutlery as normally as possible
- Involve the affected hand when carrying dishes, clothing etc
- Practice clothes fastenings: buttons, laces, zips etc
- Carry light shopping bags
- Deliberately use the hand to take items from cupboards
- Deliberately use the hand to clean and wipe surfaces.
Remember that while people are in a cast they often get into the habit of not using their hand. It is then impossible to instantly return to using the hand normally once the cast is removed. It takes time, practice and patience. Pace yourself and be prepared that there will be ups, downs and frustrations along the way, just like any long distance journey.
You may have been given a wrist support when your cast was removed. You should aim to stop using this over the next two weeks unless you have been instructed otherwise by qualified hospital staff.
You may contact the Hand Therapy Service on 01254 734119 if, after following the given advice, your symptoms get worse or you are unable to regain acceptable movement and function.