Hand therapy for a fractured wrist

A fractured wrist is a break or crack in one or more of the wrist bones. It’s a common injury that typically occurs as a result of a fall or accident.

People with fragile bones (for example, osteoporosis) are more susceptible. The main symptoms for a wrist fracture include pain, swelling and immobility.

Real-life causes

“I landed on my wrist while playing soccer.”
“I was involved in a car accident.”
“I fell off a ladder and put my weight on my outstretched arm.”


If the pain, swelling or bruising in your wrist and hand fails to subside, it’s important you seek medical attention. You’ll need an x-ray to identify whether you’ve sustained any injury to the bone. The most common type of fractures following a fall is a distal radius fracture. This is a break at the end of the radius bone close to the wrist.


Initially, your hand therapist will stabilise your arm with a backslab until the swelling or bruising has settled down. A backslab is a half cast that doesn’t encircle the wrist.

Once the initial swelling has settled, a fibreglass cast is often needed. A cast will support your arm for several weeks to allow the soft tissue and bone to heal. A waterproof cast can be used so that you can get your arm wet in the shower or pool.

Your hand therapist will work closely with your GP to manage your fracture. In some cases, you may be referred to a see a hand specialist for further imaging and examination.


Casts are normally removed after 6 weeks. If the bone has to be reset (manipulated into its original position), you may need to return for periodic x-rays. It’s normal for there to be some stiffness for a month or two after your cast is removed and it may take several months to regain normal strength. Your hand therapist will guide you through some recovery exercises.

It’s important you don’t drive, play sport or return to other physical activities until you have clearance from your doctor.

Do you need surgery for a fractured wrist?

In some cases, wrist fractures may require ORIF surgery (pin and plate surgery). This procedure involves the surgeon making an incision and realigning the fractured bone into the correct position. The bone is internally held in place with pins, screws and/or wires. The incision is then closed up using stitches or sutures.

Post-operative care

After surgery, you’ll be discharged from hospital with your hand supported in a backslab. It’s important to keep your hand elevated at this time to reduce swelling and bruising.

At your first hand therapy appointment (usually 1-2 weeks after surgery), your hand therapist will change your dressing and fit you with a removable splint. In consultation with your surgeon, they’ll also help you get started with finger, thumb and wrist exercises.

You must keep your hand clean and dry until your wound is fully healed.

Possible complications of a wrist fracture

  • Bone fails to heal
  • Ongoing swelling, pain and stiffness
  • Compromised function or strength in the hand or wrist
  • Post-traumatic arthritis
  • Nerve, tendon and other soft tissues injuries
  • Surgical pin-site or incision infections