Distal Radius Fracture Repair Recovery
Distal Radius Fracture ORIF
What the operation does
The radius is the larger of the two forearm bones, and its lower end forms most of the wrist joint. When it breaks there, the fragments are brought back into position and held with a metal plate and screws — usually placed on the palm side of the bone, under the tendons that bend the fingers. Fixing it restores the shape and length of the bone so the wrist works properly while the fracture heals.
Move your fingers from the first day
The most important instruction on this page, and the one most often underestimated. The plate holds the bone; nothing you do with your fingers will disturb it. What you can lose in the first fortnight is the hand — fingers that stiffen in a swollen hand are far harder to free later than the wrist ever is. Making a full fist and fully straightening the fingers, many times a day, is not optional extra work. It is the operation's aftercare.
Keep the hand above your heart
The other half of the same instruction. Swelling is what stiffens fingers, and gravity is what causes swelling. A hand resting in a sling at waist height is not elevated — it needs to be higher than your heart, propped on pillows when sitting, on the opposite shoulder when standing, and supported on cushions overnight. Most people who arrive at two weeks with a stiff, puffy hand spent those two weeks with it down.
Why the wrist is not the main worry
Worth reframing, because people focus on the wrist and lose the hand. The plate makes the fracture stable enough that wrist movement can usually begin within a couple of weeks, and the wrist itself tends to recover reasonably. Fingers, thumb, elbow and shoulder are what stiffen from disuse, and all of them should be moving from the start.
The plate on the palm side
Most plates sit on the palm side of the radius, tucked beneath the tendons that bend the fingers and thumb. That position is chosen because it is well covered, and it usually causes no trouble at all. Where a plate sits slightly proud, or the screws are slightly long on the back of the bone, it can irritate a tendon.
Tendon irritation and rupture
Uncommon but the recognised hardware problem here. A tendon running across a plate or a prominent screw can fray and, rarely, rupture — most often the tendon that lifts the thumb. It usually announces itself as new pain or a sudden inability to lift the thumb or a finger, sometimes months later. It is repairable, and it is one reason plates are occasionally removed once the fracture has healed.
Numbness and tingling in the hand
Common after this fracture, because the median nerve runs immediately in front of the broken bone and is bruised by the injury and the swelling. Tingling in the thumb, index and middle fingers usually settles over weeks as swelling goes down. Nerve gliding exercises are in the programme for that reason. Numbness that is worsening, or waking you at night, is worth reporting.
When pain seems out of proportion
A small number of people develop a pain response after a wrist fracture that is more intense and more persistent than the injury explains, sometimes with the hand becoming swollen, stiff, sweaty or altered in colour. It is uncommon, it is recognised, and it responds much better to being addressed early than late — largely through keeping the hand moving and used normally. Mentioning it to your care team early is the useful thing rather than waiting to see.
How much wrist movement to expect
Most people regain enough for daily life within three to six months, though few regain exactly the movement of the other wrist. Bending the wrist back and turning the palm upward are usually the last to return. Where the fracture involved the joint surface, some permanent stiffness is more likely.
Grip strength returns slowly
The part people find most frustrating. Grip is often around half the other side at six weeks and continues improving for a year or more. Opening jars, wringing out a cloth and carrying shopping in that hand are the practical milestones, and they arrive later than wrist movement does.
When the bone is healed
Judged on X-rays, usually somewhere around six to eight weeks. The plate makes the wrist feel usable well before that, which is why lifting and weight through the hand wait for the X-ray rather than for how it feels.
If a plate was not used
Many of these fractures are treated in a cast after being pushed back into position, and that works well when the fracture stays where it is put. Fixation is generally chosen where the position could not be held, where the joint surface is involved, or where an early return of function matters. If yours was fixed, it was because a cast was judged unlikely to give as good a wrist.
Driving and work
Driving generally waits until you are out of any splint and can grip and turn the wheel confidently with both hands — commonly around four to six weeks. Desk-based work is often possible within one to two weeks, and typing is usually encouraged. Manual work involving gripping, lifting or vibrating tools commonly waits three months or longer.
How the first year usually unfolds
Two weeks dominated by elevation and finger movement, with the wrist protected. Two to six weeks brings wrist and forearm movement back. Six to twelve weeks brings grip and wrist strengthening, and usually X-ray confirmation that the bone has healed. Three to six months brings most daily activity and heavier use. Grip strength and the last of the movement continue improving through the rest of the year.
Staying in touch with your care team
The fracture pattern, whether the joint surface was involved, and your bone quality all shape this recovery, and your surgeon is following it on X-ray. If something about your recovery is worrying you or does not match what is described here — particularly a sudden inability to lift the thumb, or pain that is escalating rather than settling — contact your care team rather than waiting.
Exercises for Distal Radius Fracture Repair
An illustrated, phase-by-phase exercise program for this procedure. View the Distal Radius Fracture Repair exercise program.
Recovery education · Condition guides · Exercise programs
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This guide is general education and doesn't replace evaluation by a licensed provider. Recovery and treatment vary by person — follow the guidance of your own surgeon or care team.