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Open reduction internal fixation (ORIF) of wrist fracture


You have just undergone internal fixation of your wrist fracture/break with Mr Wang.

This is usually done with a plate and screws construct. The radius and/or the ulna bone of the wrist may have been fixed. 

The following is an example of such a fracture treated with a plate and screws


Post operative recovery

Weeks 0-2 following surgery

  • Most of the time, a plaster is not required. Your wrist will be wrapped in a bulky bandage which will help protect the wound.

  • Frequently move your fingers/thumb, even if you are in a cast/plaster. 

  • Stretch your fingers out all the way with the assistance of the other hand,

  • Then close it all the way into a fist, with the assistance of the other hand if necessary

  • Early numbness or tingling in the first 24 hours following surgery is not uncommon. This may be due to the local anaesthesia Mr Wang placed into your wound to help with the pain. 

  • Keep your arm elevated at all times if possible. This is particularly important in the first 5-7 days following surgery. This helps with reducing swelling. Use a pillow to prop your arm up if you are seated or lying. 

  • Please do not lift anything heavier than a cup of tea at this time. 

  • Please keep your dressing/bandage dry at all times. You may use a plastic bag tied at/above the elbow to prevent the dressing/wound from getting wet during shower/bathing

Following cast/dressing removal

  • This may occur between weeks 2 to 6 following surgery, depending on the underlying condition. 

  • After the cast/dressing is removed, it is important you start moving your wrist to regain range of motion. Mr Wang may ask you to see a physiotherapist to help with this. 

  • There are 4 major wrist movements to regain: flexion/extension/pronation/supination. Mr Wang and/or the physiotherapist will give you instructions in these. You may start all "active" and "passive" range of motion. 

  • Experiencing some pain is normal while you try to move your wrist. 

  • Sometimes, the elbow can also be stiff at this point due to the surgery or postoperative immobilization. It is a good idea to ensure you bend and straighten the elbow to regain freedom of movement. 

  • At this time, please continue to avoid lifting anything heavier than a cup of tea. 

  • Strengthening of your wrist/hand muscles can begin at 6 weeks post surgery. 

Following bone healing

  • This may occur between 6 weeks and 4 months following surgery, depending on your age and the exact break pattern. Sometimes the bones may not heal until even later.

  • Bone healing is usually determined on xray, and Mr Wang will advise you when there is sufficient healing to progress with your activities.

  • Once sufficient bone healing has occurred, you could then increase weight-bearing of the arm, and gradually return to sports.

  • Therapy at this stage will focus on regaining strength and progression back to sporting activities. 

  • In most situations, the plate and screws does not need to be removed. Mr Wang will have a discussion with you regarding the pros and cons of hardware removal. 

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