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Fratura do Rádio Distal (ORIF)

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Staged rehabilitation after plate fixation of a distal radius fracture, from the first days to return to full activity.

Updated Jun 2026
Ilustração dos ossos do pulso com uma placa metálica e parafusos fixando o rádio.
Uma placa e parafusos fixando o rádio após uma fratura do punho. Kieran Hirpara 4.0

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

Este protocolo orienta a sua recuperação após a fixação cirúrgica de uma fratura do rádio distal (pulso) (redução aberta e fixação interna, RAFTI) com o Dr. Kieran Hirpara no Mater Private Hospital Rockhampton. Começa com o seu programa de exercícios em casa, seguido pelo protocolo clínico estruturado escrito para o seu fisioterapeuta ou terapeuta da mão: traga esta página ou o seu PDF para a sua primeira sessão de terapia, de modo a que a sua reabilitação permaneça coordenada. O seu terapeuta pode ajustar o plano dependendo da evolução da sua recuperação.

Se tiver alguma preocupação sobre a sua ferida após a cirurgia, entre em contacto com a clínica. É frequentemente útil tirar uma fotografia da ferida e enviá-la por e-mail para avaliação.

O que esperar

Para o cuidado da ferida, controle do inchaço e cicatriz, consulte as orientações de cuidados com a ferida da prática médica.

Após a sua cirurgia, você pode ser encaminhado a um terapeuta da mão para a confecção de uma tala de termoplástico. Nesse caso, a tala será usada temporariamente para conforto e proteção, e você ainda será obrigado a removê-la para realizar seu programa de exercícios em casa. Se você for encaminhado para o uso de uma tala, receberá mais informações sobre o uso e os cuidados necessários.

Os exercícios abaixo são essenciais para recuperar a amplitude de movimento dos dedos, do punho e do antebraço. Calor e gelo são modalidades frequentemente utilizadas para recuperar o movimento, restaurar a função e melhorar o conforto. Uma vez que a ferida esteja cicatrizada, você pode aplicar calor antes dos exercícios; uma compressa gelada pode ser usada após os exercícios para prevenir ou reduzir a inflamação.

O manejo da cicatriz (especialmente a massagem) é muito importante após a cirurgia de fratura distal do rádio, para que os tendões que passam sob a incisão continuem deslizando livremente e não fiquem aderidos (aderentes) à cicatriz em processo de cicatrização.

Uma placa volar bloqueada é projetada para manter a fratura firmemente fixada o suficiente para que o movimento possa começar precocemente, e este protocolo é baseado nesse princípio. Pesquisas que comparam o início precoce do movimento do punho com várias semanas de imobilização após a fixação com placa volar mostram que iniciar o movimento precocemente pode melhorar o movimento a curto prazo, a força de preensão e o conforto, sem comprometer a posição da fratura [1][2]. Ao mesmo tempo, ensaios clínicos que compararam o início do movimento do punho por volta de duas semanas com o início por volta de seis semanas encontraram resultados semelhantes entre os dois grupos aos três a seis meses [3], portanto, embora haja um benefício inicial, não há necessidade de pressa, e a progressão constante descrita abaixo é bem fundamentada. A consolidação óssea segue seu próprio cronograma, independentemente da sensação do punho, razão pela qual as precauções posteriores (sem apoio de peso, levantamento de cargas pesadas ou esportes de contato até 12 semanas após a fratura) são mantidas mesmo quando o movimento se torna confortável.

Precauções e limitações

O uso funcional leve da sua mão é incentivado para tarefas diárias, como cuidados pessoais, alimentação, vestir-se, escrever e digitar.

É importante evitar levantar pesos, agarrar, suportar peso e impactos durante até 8 semanas após a sua cirurgia. O fortalecimento suave é introduzido gradualmente a partir da semana 4, começando com exercícios leves dos dedos e exercícios isométricos do punho, sendo progressivamente intensificado com cuidado para não comprometer essa proteção inicial.

Estes são os exercícios do seu folheto informativo, para recuperar a mobilidade dos dedos, punho e antebraço. Se estiver usando uma tala, remova-a para realizar os exercícios. Inicie-os conforme orientado pelo Dr. Hirpara e pelo seu terapeuta.

Seus exercícios

Seu protocolo clínico

O restante desta página é o protocolo clínico acelerado para uma fratura do rádio distal tratada com redução aberta e fixação interna com placa volar. Esta seção deve ser fornecida ao seu fisioterapeuta ou terapeuta da mão, e cada fase abaixo começa com uma explicação em linguagem simples do que está acontecendo.

Dias 1–4 após a sua cirurgia

Nos primeiros dias, o foco é proteger a fixação, reduzir o inchaço e manter os dedos, o pulso, o antebraço, o cotovelo e o ombro em movimento. A sua bandagem cirúrgica permanece no lugar até ao dia 3, altura em que é reduzida e a ferida é reaparelhada. Mantenha a mão elevada quando estiver em repouso, utilize-a para tarefas diárias leves (menos de 1–2 kg) dentro dos limites de conforto e evite suportar peso através do braço, agarrar com força ou levantar objetos. Uma tala não é rotineiramente necessária, mas pode ser providenciada se estiver a regressar ao trabalho ou se o pulso estiver mais doloroso.

Para o seu fisioterapeuta:

Antes do tratamento, verifique os raios X do paciente, o relatório da operação e o histórico médico (PMHx), e entre em contacto com o cirurgião tratante relativamente à estabilidade da fixação da fratura e ao provável prognóstico.

Educação e precauções

  • Evite suportar peso através do braço, agarrar com força ou levantar objetos
  • Incentive a utilização da mão afetada para atividades da vida diária (AVD) leves (menos de 1–2 kg) dentro dos limites de dor e dos padrões normais de movimento

Gestão

  • Tala: não é necessária, mas pode ser utilizada se o paciente estiver a regressar ao trabalho ou na presença de dor aumentada; considere uma tala termoplástica ou um suporte pronto a usar
  • Ferida: as bandagens/cobertura cirúrgica devem permanecer intactas até ao dia 3; reduzir o volume da bandagem e reaparelhar a ferida a partir do dia 3 pós-operatório; educação relativa à gestão da ferida
  • Edema: fornecer educação relativa à elevação; fornecer terapia de compressão e massagem retrógrada conforme necessário
  • Exercícios: fornecer exercícios ativos em seis pacotes para manter a amplitude de movimento (ROM) dos dedos; fornecer exercícios ativos de amplitude de movimento do pulso, antebraço e dedos; incentivar a amplitude de movimento ativa regular do cotovelo e do ombro

Semana 2–4 após a sua cirurgia

Os pontos são removidos entre o 10.º e o 14.º dia, e a massagem da cicatriz inicia-se assim que a ferida tenha cicatrizado suficientemente. O programa de exercícios continua (os exercícios do "pacote de seis" cessam assim que os dedos recuperam o movimento completo) e começa o fortalecimento suave do pulso através de ativação muscular (isométrico). Durante esta fase, o pulso deve continuar a mover-se apenas sob o poder muscular: ninguém, incluindo o próprio doente, deve empurrar ou alongá-lo passivamente, uma vez que a fratura ainda está em processo de consolidação. Continue a evitar a carga de peso, a preensão forte e o levantamento de pesos; são incentivadas tarefas diárias ligeiras com menos de 1–2 kg. Não deve conduzir enquanto o pulso estiver em tala; a condução retoma assim que sair da tala, conforme confirmado na sua consulta de seguimento.

Para o seu fisioterapeuta:

Avaliações

  • Avaliações autorrelatadas: Avaliação do Pulso Relatada pelo Doente (PRWE), Incapacidades do Braço, Ombro e Mão (DASH)
  • Medidas circunferenciais do edema
  • Escala visual analógica da dor (VAS) ou escala de classificação numérica
  • Medidas de goniometria da amplitude de movimento ativa (AMA): mão, pulso
  • Revisão subjetiva, incluindo a adesão do doente ao regime, a utilização funcional da mão nas tarefas de AVD e problemas/preocupações

Educação e precauções

  • Evitar a carga de peso através do braço, preensão forte ou levantamento de pesos
  • Sem movimento passivo do pulso
  • Incentivar a utilização da mão afetada para tarefas ligeiras de AVD (menos de 1–2 kg) dentro dos limites da dor e dos padrões de movimento normais
  • Não conduzir enquanto estiver em tala; a condução retoma assim que sair da tala, confirmado na consulta de seguimento

Gestão

  • Ferida/cicatriz: remoção dos pontos entre o 10.º e o 14.º dia; iniciar a gestão da cicatriz conforme apropriado, dependendo do progresso da cicatrização
  • Edema: considerar o uso de bandagem compressiva, massagem retrógrada, mobilização manual do edema (MEM), banhos contrastantes e/ou elevação, se necessário
  • Exercícios: cessar os exercícios ativos do "pacote de seis" assim que a amplitude completa dos dedos seja alcançada; considerar exercícios passivos dos dedos e do polegar, incluindo place/hold (colocar/manter), se a amplitude de movimento ativa não estiver completa na mão; continuar os exercícios de amplitude de movimento ativa do pulso; incentivar a amplitude de movimento ativa regular do cotovelo e do ombro; iniciar o fortalecimento isométrico do pulso

Resolução de problemas

  • Monitorizar sinais de infeção da ferida, alterações sensoriais na mão ou sinais precoces de síndrome dolorosa regional complexa (SDRC)
  • Identificar padrões de movimento aberrantes e intervir conforme necessário

Semana 4–6 após a sua cirurgia

O fortalecimento começa de forma suave nesta fase: fortalecimento dos dedos com baixa resistência a partir da semana 4, enquanto o trabalho isométrico do punho continua e é gradualmente intensificado. Se a radiografia for satisfatória e a fixação for estável, alongamentos passivos suaves do punho (em que o punho é movido com ajuda da outra mão ou do fisioterapeuta) podem ser iniciados entre as 4 e as 6 semanas. Restaurar o movimento continua a ter prioridade em relação ao ganho de força. Continue a evitar a carga de peso através do braço e o levantamento de pesos pesados, enquanto continua a utilizar a mão para tarefas diárias leves.

Para o seu fisioterapeuta:

Avaliações

  • Medidas circunferenciais do edema
  • Escala visual analógica da dor ou escala de classificação numérica
  • Medidas de goniometria do ROM ativo e qualidade dos padrões de movimento
  • Revisão subjetiva, incluindo a adesão do paciente ao regime, o uso funcional da mão nas tarefas de AVD e problemas/preocupações
  • Força de preensão utilizando dinamômetro (3 tentativas em cada membro)

Educação e precauções

  • Evitar a carga de peso através do braço ou o levantamento de pesos pesados
  • Incentivar o uso da mão afetada para tarefas de AVD leves (menos de 1–2 kg) dentro dos limites da dor e dos padrões de movimento normais

Gestão

  • Cicatriz: continuar a gestão da cicatriz conforme necessário
  • Edema: continuar a terapia de compressão, massagem retrógrada, MEM e elevação conforme necessário; interromper o banho contrastante
  • Exercícios: continuar os exercícios passivos dos dedos e do polegar se o ROM não estiver completo; continuar os exercícios de ROM ativo do punho; iniciar exercícios de fortalecimento dos dedos com baixa resistência na semana 4; iniciar exercícios passivos suaves do punho entre as 4 e as 6 semanas se a ORIF estiver estável e a radiografia for satisfatória; incentivar o ROM regular do cotovelo e do ombro; continuar/intensificar os exercícios de fortalecimento isométrico do punho

Resolução de problemas

  • Avaliar sinais de SDRCC e dor no ombro
  • Considerar o volume de exercícios no programa doméstico e priorizar o ROM em relação à força
  • Se o ROM do punho estiver significativamente limitado, considerar o início de exercícios passivos suaves de amplitude de movimento (PROM) do punho dentro de 4/10 na EVA, com aprovação do cirurgião

Semana 6–8 após a sua cirurgia

Esta fase inicia um retorno gradual à atividade plena ao longo das próximas 3 semanas. O fortalecimento do pulso avança para pesos leves (0,5–1,0 kg) ou theraband de baixa resistência, e a resistência para o fortalecimento dos dedos aumenta. Dois limites rígidos permanecem: sem apoio de peso, levantamento de cargas pesadas ou desportos de contato até 12 semanas após a fratura. O seu terapeuta considerará a sua alta quando tiver amplitude de movimento completa e um retorno adequado da função.

Para o seu fisioterapeuta:

Avaliações

  • Medidas circunferenciais do edema, conforme necessário
  • Escala visual analógica de dor ou escala de classificação numérica
  • Medidas de goniometria da ADM ativa
  • Força de preensão
  • Revisão subjetiva

Educação e precauções

  • Retorno gradual à atividade plena ao longo das próximas 3 semanas
  • Evitar apoio de peso, levantamento de cargas pesadas e desportos de contato até 12 semanas pós-fratura

Gestão

  • Cicatriz: continuar a gestão da cicatriz, conforme necessário
  • Edema: continuar a gestão do edema, conforme necessário
  • Exercícios: continuar os exercícios passivos dos dedos e do polegar se a ADM não estiver completa; continuar os exercícios de ADM ativa e passiva do pulso, se necessário; aumentar a resistência nos exercícios de fortalecimento dos dedos; iniciar exercícios de fortalecimento do pulso com o uso de pesos de 0,5–1,0 kg ou theraband de baixa resistência; aumentar os pesos e a resistência utilizados no programa de fortalecimento do pulso, conforme tolerado

Resolução de problemas

  • Considerar/iniciar imobilização seriada progressiva noturna, luva tipo "boxing glove" ou imobilização dinâmica, se houver melhoria lenta da ADM
  • Monitorizar quaisquer sinais de instabilidade do pulso e tratar conforme apropriado
  • Considerar a alta quando a ADM completa e o retorno adequado da função estiverem presentes
  • Considerar a remissão ao médico tratante se a condição estagnar e/ou houver um resultado desfavorável

Este protocolo foi elaborado em associação com Sarah Farrell, BOccThy AHT, e Kristy Gerlach, BOccThy AHT.

Após o seu protocolo

Este protocolo complementa as orientações gerais de recuperação da clínica; consulte o manejo da dor pós-operatória, o cuidado com a ferida e os fundamentos da terapia da mão. Para informações sobre o procedimento cirúrgico e a lesão que ele trata, consulte a fixação da extremidade distal do rádio (ORIF) e a fratura da extremidade distal do rádio. O plano em fases acima está de acordo com as evidências publicadas sobre a reabilitação após a fixação com placa volar bloqueada, e sua recuperação contínua é orientada individualmente pelo seu fisioterapeuta ou terapeuta da mão, de acordo com a evolução do seu pulso.

Referências

[1] Quadlbauer S, Pezzei C, Jurkowitsch J, et al. Mobilização imediata de fraturas da extremidade distal do rádio estabilizadas com placa de bloqueio volar resulta em melhor desfecho a curto prazo do que imobilização por cinco semanas: um ensaio randomizado prospectivo. Arch Orthop Trauma Surg. 2022;142(5):1–11. https://pubmed.ncbi.nlm.nih.gov/34852677/ [2] Gutiérrez-Espinoza H, Araya-Quintanilla F, Olguín-Huerta C, et al. Eficácia da mobilização precoce versus tardia em pacientes com fratura da extremidade distal do rádio tratados com placa de bloqueio volar: uma revisão sistemática e meta-análise. Hand Surg Rehabil. 2020;39(4):261–271. https://www.sciencedirect.com/science/article/abs/pii/S2468122920302231 [3] Lozano-Calderón SA, Souer S, Mudgal C, Jupiter JB, Ring D. Mobilização do punho após fixação com placa volar de fraturas da parte distal do rádio. J Bone Joint Surg Am. 2008;90(6):1297–1304. https://pubmed.ncbi.nlm.nih.gov/18519324/ [4] Miller LK, Jerosch-Herold C, Shepstone L. Eficácia das técnicas de manejo do edema para edema subagudo da mão: uma revisão sistemática. J Hand Ther. 2017;30(4):432–446. https://pubmed.ncbi.nlm.nih.gov/28807598/

Reviewed by Dr Kieran Hirpara · 10 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

Distal Radius Fracture (ORIF) — Post-operative Rehabilitation Evidence Brief

Topic scope: post-operative rehabilitation after open reduction and internal fixation (ORIF) of a distal radius fracture with a volar locking plate. This brief backs an early-motion-but-protected hand/wrist pathway delivered with hand therapy, where wrist motion begins early while bone-dependent loading (weight-bearing, heavy lifting, contact sport) is deferred until ~12 weeks. It does not cover the indications for surgery vs casting, nor fragment-specific/dorsal/bridge-plate constructs (which carry their own loading rules).

Defining principle of the rehab here: a volar locking plate is a fixed-angle construct stable enough to permit immediate wrist motion — the screws lock to the plate and hold the articular reduction independent of the cast. So (unlike a cast-treated fracture, and unlike a tendon or ligament repair) the wrist does not need weeks of immobilisation to protect the reduction: the rehab is an early-movement pathway — finger/forearm/wrist active motion and oedema control from day one, splint for comfort only, isometric then progressive strengthening from ~weeks 4–6. The one timeline that is not negotiable is bone healing: union takes ~6–12 weeks regardless of how the wrist feels, which is why weight-bearing, heavy lifting and impact are held to 12 weeks even once motion is comfortable.

A. PROCEDURE & CONSTRUCT — what the rehab is protecting

Volar locking plate fixation is the dominant operative construct for displaced distal radius fractures and is the reference standard against which other techniques are compared. Key surgical-outcome facts that shape the rehab:

  • Volar locking plates restore and hold articular reduction reliably, and across randomised comparisons give equivalent or better functional outcomes than non-operative care and competing fixation methods (dorsal plating, intramedullary nailing, fragment-specific), with most differences favouring early function rather than final endpoint [JAAOS controversies review 2014; Hand Clinics plate-fixation review 2021; IM-nail-vs-volar-plate RCTs].
  • The fixed-angle construct is the rationale for early motion. Because the locking screws hold the subchondral fragments rigidly, the plate — not a cast — maintains the reduction, so wrist motion can start before union without displacing the fracture [Hand Clinics 2021; accelerated-rehab RCT, JBJS 2014].
  • In older patients the operative-vs-conservative outcome gap is small. A 3-year RCT in patients >70 found volar plating and non-operative care converged on similar patient-reported function — context that keeps post-operative rehab pragmatic and patient-centred rather than aggressive [BMC Musculoskelet Disord 2022; Hand Clinics geriatric review 2021].
  • Recovery is gradual. Range, grip and patient-reported scores improve steadily over the first 3–6 months; the construct permits early motion but does not accelerate the biology of healing or the return of grip strength.

B. REHABILITATION / HAND-THERAPY EVIDENCE

The central rehab questions for this construct are (1) when to start wrist motion, (2) how much supervised therapy is needed, and (3) what the strengthening timeline should be. The evidence is clear on the first, nuanced on the second, and consensus-driven on the third.

  • Early motion is safe and gives a short-term advantage. Multiple RCTs and a systematic review show that starting wrist motion early after volar plating improves short-term ROM, grip and comfort without compromising the radiographic reduction [accelerated-rehab RCT, JBJS 2014; early-vs-late motion RCT, HAND 2018; Hand Therapy systematic review 2020]. This is the direct warrant for the day-1 finger/forearm/wrist program in this protocol.
  • "Early" need not mean "immediate," and the advantage washes out by 3–6 months. The landmark trial comparing wrist mobilisation at ~2 weeks vs ~6 weeks found the two groups equivalent by 3–6 months [Lozano-Calderón / JBJS 2008]. So there is a genuine early benefit but no penalty for a measured, comfort-led progression — which is exactly why this protocol can be unhurried.
  • Routine supervised physiotherapy adds little over a coached home program for most patients. Systematic reviews and RCTs repeatedly find that a structured home exercise program preceded by instruction/coaching performs as well as formal supervised therapy for uncomplicated cases, and that prescribed exercise programs add limited benefit over advice for impairment/activity outcomes [HEP-vs-supervised SR, J Hand Ther 2014; J Physiother SR 2017; Hand Clinics "is therapy needed?" 2021; Arch Orthop Trauma Surg 2020]. This supports a home-program-first model with hand-therapy review, escalating supervision for stiffness, oedema or slow progress — the structure of this protocol.
  • Oedema control and scar/tendon-glide management are standard therapy elements. Elevation, retrograde massage, manual oedema mobilisation and (early) compression are the evidence-informed oedema toolkit [edema-management SR, J Hand Ther 2017]; scar massage to keep the flexor tendons gliding under the volar incision is consensus hand-therapy practice rather than RCT-derived.

Phased post-op timeline (volar locking plate, early-motion pathway)

Phases match this topic's synthesis.md. Timings are post-operative weeks; the 12-week loading limit is referenced to the fracture (injury) date.

Phase Window Splint Motion / use Strengthening Notes
I — Protect & move Days 1–4 Comfort only, not routine Active finger (six-pack), wrist, forearm, elbow & shoulder ROM from day 1; light ADL < 1–2 kg within pain limits — Surgical bandage to day 3, then redress. Oedema control + elevation. No weight-bearing, gripping or lifting
II — Active range & oedema Week 2–4 Comfort/work only (no driving while splinted) Continue active wrist ROM (no passive yet); six-pack stops once fingers full Isometric wrist activation begins Sutures out day 10–14; start scar massage once healed. Watch for CRPS. PRWE/DASH baseline
III — Passive range & light load Week 4–6 Off Add gentle passive wrist stretches at 4–6 wk if x-ray satisfactory & fixation stable Finger strengthening (low resistance) from wk 4; upgrade isometrics Movement still prioritised over strength
IV — Graded strengthening & return Week 6–8 Off Restore/maintain full active & passive ROM Wrist strengthening with 0.5–1.0 kg / light theraband, progress as tolerated Graded return over ~3 wk. No weight-bearing, heavy lifting or contact sport until 12 weeks post-fracture. Discharge on full ROM + functional return

The phase structure mirrors published surgeon/hand-therapy ORIF protocols (early ROM → scar + oedema → passive range + light resistance → progressive strengthening, with heavy load/sport held to ~12–16 weeks) [Physiopedia Colles' ORIF protocol; institutional ORIF rehab guidelines].

C. KEY CONTROVERSIES / EVIDENCE QUALITY

  1. How early to mobilise. Early motion (immediate–2 wk) gives a real short-term ROM/grip/comfort advantage that equalises by 3–6 months vs starting at ~6 weeks. The evidence therefore supports early motion but does not mandate aggression — a measured progression is fully defensible. Moderate–strong (multiple RCTs + SR).
  2. Supervised therapy vs coached home program. For uncomplicated fractures the best available evidence finds no consistent benefit of routine formal physiotherapy over a well-instructed home program; supervision is best targeted to stiffness, oedema, CRPS risk or slow progress. Moderate (SRs/RCTs), but heterogeneous.
  3. Strengthening and return-to-load timing. The week-by-week strengthening ramp and the 12-week loading hold are construct- and biology-based consensus, drawn from surgeon/hand- therapy protocols rather than a strengthening-timing RCT. Weak/consensus.
  4. Whether the wrist needs any immobilisation at all. Some trials report that omitting post-op immobilisation does not worsen outcomes after volar plating, supporting the "splint for comfort only" stance here. Moderate.

D. EVIDENCE STRENGTH FLAGS (summary)

  • STRONG / MODERATE–STRONG (RCT / SR): early wrist motion after volar plating is safe and improves short-term ROM/grip/comfort without loss of reduction (accelerated-rehab RCT JBJS 2014; early-vs-late RCT HAND 2018; Hand Therapy SR 2020); ~2-wk vs ~6-wk mobilisation equivalent by 3–6 months (Lozano-Calderón JBJS 2008).
  • MODERATE: volar locking plate is a reliable fixed-angle construct with equivalent/favourable outcomes vs alternatives (JAAOS 2014; Hand Clinics 2021); operative-vs-conservative outcomes converge in the elderly (BMC 2022); coached home program ≈ supervised therapy for uncomplicated cases (J Hand Ther 2014; J Physiother 2017; Hand Clinics 2021); evidence-based oedema management (J Hand Ther 2017).
  • WEAK / CONSENSUS: the detailed strengthening ramp and 12-week loading limit (surgeon & hand-therapy protocols; biology- and construct-based, not trial-derived); scar/tendon-glide massage practice.

CITATIONS

RAG corpus (180,000+ Orthopaedic articles)

  • Accelerated rehabilitation compared with a standard protocol after distal radial fractures treated with volar open reduction and internal fixation. J Bone Joint Surg Am. 2014. DOI: 10.2106/jbjs.m.00860
  • Wrist mobilization following volar plate fixation of fractures of the distal part of the radius. J Bone Joint Surg Am. 2008. DOI: 10.2106/jbjs.g.01368
  • Early versus late motion following volar plating of distal radius fractures. HAND. 2018. DOI: 10.1177/1558944718787880
  • A systematic review of how daily activities and exercises are recommended following volar plating of distal radius fractures and the efficacy and safety of early versus late mobilisation. Hand Therapy. 2020. DOI: 10.1177/1758998320967032
  • AAOS/ASSH Clinical Practice Guideline Summary: Management of Distal Radius Fractures. J Am Acad Orthop Surg. 2022. DOI: 10.5435/jaaos-d-21-00719
  • Controversies in the management of distal radius fractures. J Am Acad Orthop Surg. 2014. DOI: 10.5435/jaaos-22-09-566
  • Plate fixation of distal radius fractures. Hand Clinics. 2021. DOI: 10.1016/j.hcl.2021.02.008
  • Non-operative treatment or volar locking plate fixation for dorsally displaced distal radius fractures in patients over 70 years — a three-year follow-up of a randomized controlled trial. BMC Musculoskelet Disord. 2022. DOI: 10.1186/s12891-022-05394-7
  • Distal radius fracture: HEP versus supervised therapy — a systematic review. J Hand Ther.
  • DOI: 10.1016/j.jht.2013.08.017
  • Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review. J Physiother. 2017. DOI: 10.1016/j.jphys.2017.08.009
  • Is therapy needed after distal radius fracture treatment — what is the evidence? Hand Clinics.
  • DOI: 10.1016/j.hcl.2021.02.012
  • Rehabilitation after distal radius fractures: is there a need for immobilization and physiotherapy? Arch Orthop Trauma Surg. 2020. DOI: 10.1007/s00402-020-03367-w
  • Management of complications of distal radius fractures. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2014.12.002
  • A comparison of the accuracy of two sets of diagnostic criteria in the early detection of complex regional pain syndrome following surgical treatment of distal radial fractures. J Hand Surg Eur Vol. 2012. DOI: 10.1177/1753193412469142

Distal radius / rehabilitation literature (URLs)

  • AAOS/ASSH Clinical Practice Guideline Summary: Management of Distal Radius Fractures (full summary). PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC9196973/
  • Practical application of the 2020 distal radius fracture AAOS/ASSH clinical practice guideline: a clinical case. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC9035062/
  • Rehabilitation for distal radial fractures in adults (Cochrane-style review). PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC9250132/
  • Rehabilitation after distal radius fractures: opportunities for improvement. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC10569825/
  • Rehabilitation following surgically treated distal radius fractures: do immobilization and physiotherapy affect the outcome? PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8343619/

Published rehab protocols (surgeon / hand-therapy — basis for the phase structure)

  • British Society for Surgery of the Hand / British Association of Hand Therapists — Distal Radius Fractures Working Group rehabilitation guidance (2024). https://www.hand-therapy.co.uk/_userfiles/pages/files/distal_radius_fractures_working_group_2024.pdf
  • Colles' Fracture Post-Operative Rehabilitation Protocol. Physiopedia. https://www.physio-pedia.com/Colles%E2%80%99_Fracture_Post_Operative_Rehabilitation_Protocol
  • Distal Radius ORIF Rehabilitation Guidelines. University of Virginia Department of Orthopaedic Surgery. https://med.virginia.edu/orthopaedic-surgery/wp-content/uploads/sites/242/2024/09/Distal-radius-ORIF.pdf
  • Distal Radius ORIF Rehabilitation. Jared Lee, MD. https://jaredleemd.com/pdf/distal-radius-orif-rehabilitation/

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