certified hand therapy for distal radius fracture

Posted by & filed under Hand/Wrist.

How occupational therapy can help after a wrist fracture.

As an occupational therapist with a hand therapy clinic in Miami, wrist fractures are a common diagnosis that I treat.  Anything that is near the wrist, people call a wrist injury.  But you actually have 8 small wrist bones and then 2 longer forearm bones called the radius and the ulna that make up your “wrist”.  Today, I want to talk about fractures to the distal radius.

gross drawing of distal radius

gross drawing of distal radius

Fractures to the distal radius can occur when you fall on an outstretched hand.  It is pretty much about the angel and force of the fall.  The broken area can get swollen really fast and it can look deformed.  Sometimes, people think just because the fingers can move that the wrist is not broken (one of my patients told me that last week….that’s why I mention it).  If you are not sure, go to the doctor, urgent care, or emergency room and get an x-ray.  Most of the time there’s a lot of pain and there is limited motion due to the break.

How bad the break is determines what happens next.  Most of the time (but don’t quote me on this…) if you go the ER or urgent care center, they will x-ray you, then place you in a protective splint.  Then you are instructed to follow up with an orthopedic/hand doctor.  If your bone is broken in a few pieces but is non-displaced, meaning the bones for the most part are still sitting together.  If they can keep it stable, you may be placed in a cast, and follow up in a month.  If your bone is broken in several pieces to many pieces and is displaced, meaning there is a lot of space between the pieces, you may need surgery.   There are a lot of scenarios (I am just giving you two simple ones) and some options that your doctor can give you and you must decide what is right for you.

Not everyone that breaks their distal radius requires occupational therapy or certified hand therapy.  However, I wanted to give you some tips that I like to education my own patients about.

 

Miami occupational therapists

custom fitted orthosis

 

  1. If the wrist/distal radius is broken and you are in a cast or splint, please make sure that you are fully able to move your fingers all the way down.  It is your big knuckle (the MP joint) that needs to bend all the way down.  If it is blocked, you can develop a stiff hand and need a lot of painful occupational therapy.
  2. If you are given a prefabricated splint but it’s too big or it doesn’t fit, look for an occupational therapist or certified hand therapy clinic in your local area (like here in Miami) and have a custom fitted orthosis made for you. Yes, I know…it’s more expensive, but honestly, if it doesn’t fit and you can’t move, let me tell you that you will be spending a lot more in therapy just to get going.
  3. Your wrist is broken, not everything else!! Dear lord keeping everything else moving!  Don’t let your shoulder and elbow get tight!  And please don’t let you fingers get stiff…
  4. Not sure about when to start occupational/certified hand therapy? It’s better to call your therapy center and ask.  They will ask you a few questions and help you determine when you need to come in.  But I know that if you are painful and can’t move well, it’s better to come in earlier then later.

Every doctor’s protocol can be different.  But when I worked with one surgeon several years back, I did all the post-op cast removal 5 days after surgery, fitted them with a custom fitted orthosis, and started them gently moving.  Results can be great.  Now I work with so many doctors and there is a general protocol, but some stick to their own protocol.  So it’s never too early but your therapist needs to know the protocol and how to progress.  Also ask your doctor.  Sometimes they order therapy, sometimes they wait, but you can always ask for the prescription to start therapy.  Occupational therapy and physical therapy can be directly accessed (it’s called direct access, go figure) without your doctor’s prescription as well but for the time being if you are using any kind of insurance for your therapy coverage, you still need a prescription.

Don’t be scared! Starting occupational therapy can be relieving actually.  I always explain the whole process to my patients depending on their needs.  Sometimes people need a lot of therapy and sometimes people only need a few sessions to teach them what to do.  But at least you get started on regaining your function! And with less pain and limitations!

I hope this had been helpful.  Thank you!  Have questions?  Leave a comment!

Hoang Tran OT/L, CHT

 

Hands on Therapy Services in Miami is one of the best hand therapy and occupational therapy clinics in the Miami area. Hands on Therapy Services is centrally located by the Miami International Airport, For more contact info  please click here or call us at (786) 615-9879.

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Disclaimer:  As with all our pages, this is NOT a substitute for formal medical treatment or occupational therapy.  It is intended to inform only.  Hands on Therapy Services disclaims any liability for the decisions you make based on this information.