Immediate Active Finger Motion with Wrist Support
Begin active finger motion exercises immediately while keeping your wrist rested on a flat surface, as this approach prevents the most functionally disabling complication—finger stiffness—without compromising wrist healing. 1, 2
Treatment Algorithm
Phase 1: Immediate Active Finger Motion (Days 0-21)
- Start active finger exercises on day 1, moving all fingers through complete range of motion multiple times daily while the wrist remains supported on a flat surface 1, 2, 3
- Finger motion does not adversely affect adequately stabilized wrist fractures and is extremely cost-effective, preventing complications that would otherwise require multiple therapy visits or surgical intervention 1, 2
- Hand stiffness is very difficult to treat after it develops, often requiring extensive therapy and possibly additional surgery, making early finger motion critical 1, 3
Phase 2: Wrist Immobilization Strategy
- Use a rigid wrist splint that immobilizes the wrist while allowing full metacarpophalangeal (MCP) joint motion 2
- The splint should be padded and comfortably tight but not constrictive 2
- Continue wrist immobilization for 3-4 weeks with radiographic follow-up to assess healing 2, 3
Phase 3: Progressive Wrist Mobilization (Week 3 onwards)
- Begin gentle active wrist range of motion exercises at approximately 3 weeks post-injury, based on fracture stability 4, 3
- Continue aggressive finger motion exercises throughout this phase 2
- Avoid forceful gripping, twisting, or impact activities until cleared by your physician 4
Home Exercise Program
- A home exercise program is equally effective as supervised physiotherapy for uncomplicated wrist injuries 3
- Reserve supervised therapy only for patients developing complications such as persistent stiffness or complex regional pain syndrome 3
Critical Pitfalls to Avoid
- Never restrict finger motion during wrist immobilization—failure to encourage early finger exercises leads to severe stiffness requiring extensive therapy or surgery 1, 2, 3
- Avoid over-immobilization of uninvolved fingers, which leads to unnecessary stiffness 4
- Any unremitting pain during follow-up requires immediate reevaluation, as this may indicate complications 1, 3
Work Restrictions
- Maintain sedentary duties only with no use of the affected hand for work tasks initially 4
- Avoid repetitive wrist extension, forceful gripping, weight-bearing on the wrist, and high-impact activities until cleared 4
- Gradually increase weight-bearing activities as tolerated and cleared by your physician 4