- Reference Number: HEY-1276/2022
- Departments: Orthopaedics, Physiotherapy
- Last Updated: 1 May 2022
Introduction
This leaflet has been produced to give you general information about your injury. We understand you may not have seen a clinician face to face in fracture clinic however, most of your questions should be answered by this leaflet. If after reading it, you have any concerns or require further explanation, please do not hesitate to contact the fracture clinic team. Contact details are available at the end of this leaflet.
What is a fracture of the distal radius?
The x-rays you had following your injury show that you sustained a broken radius or wrist bone. A broken bone may also be referred to as cracked or fractured – these terms mean the same thing.
Your fracture is not displaced, meaning it is in a good position, and should heal well if the advice below is followed.
How should it be treated?
This injury can be treated in a removable cast or wrist splint for 5 weeks, this will provide the support needed for the fracture to heal and will help relieve any pain you may feel. Simple medication such as paracetamol or NSAIDS (non-steroid anti-inflammatories) may help to control your pain. Speak with your local doctor (GP) or pharmacist about medication options.
After 5 weeks, it can be removed without requiring a further fracture clinic review.
It is really important to note that smoking will delay the healing process and so should be avoided. Talk to your GP or go to www.smokefree.nhs.uk for more information.
What should I do in the first few days?
Complete rest is not advisable. Whilst in the cast or splint, it is important that you try to use your hand normally when doing everyday tasks like dressing, washing and eating. Care should be taken not to get the removable cast wet.
Arm exercises are very important; you should move your shoulder, elbow and fingers regularly to prevent stiffness at these joints. The exercises below can be performed 4 times daily.
Support your elbow on a table with your wrist straight and fingers pointing towards the ceiling
- Bend your fingers into your palm as tightly as you can
- Hold the stretch 10 seconds
- Now stretch your fingers as wide as you can
- Hold the stretch for 10 second
Remove the arm from the sling and straighten it down by your side
- Now bend the elbow as much as possible
- Repeat 10 times slowly in each direction
Bend your elbow and tuck it into your side
- Turn your palm as far as possible upwards without moving your elbow
- Feel the stretch and hold for 10 seconds
- Now turn your hand back over so your palm faces downwards, feel the stretch and hold for 10 seconds
Shoulder flexion
- Hold a long stick in both your hands
- Allow your unaffected arm to help your affected arm lift forward and upward as high as possible
- In the early stages, you may find this easier laid down
If you continue to have swelling in your wrist or hand, you can reduce this by sitting on a chair and placing your elbow on cushions so that it is level or slightly higher than your shoulder. In this position, point your hand towards the ceiling, open and close your fingers slowly for 10 minutes (like in exercise 1 above).
When can I start driving again?
You will not be insured to drive whilst you are in wearing a cast or splint. It is always good to check with your insurance company however we advise it should be safe to return to driving when:
- You are no longer wearing the cast or splint
- You can comfortably grip the steering wheel, move the gear stick, pull up the hand brake and activate the indicators.
- You can perform an emergency stop
What exercises can I do once the cast splint is removed?
Rest your forearm on a table with your hand over the edge. Using your wrist only, move your hand down towards the floor
- Hold the stretch for 10 seconds
- Now move your hand towards the ceiling
- Repeat 10 times each direction
Sit with your elbow tucked in by your side, fingers straight out and your thumb uppermost. Now keeping your thumb uppermost move your fingers down towards the floor (as in the picture below). Hold 10 seconds.
- Next move your fingers and thumb back up towards the ceiling, without moving your elbow
- Hold 10 seconds
Bend your elbow and tuck it into your side
- Turn your palm as far as possible upwards without moving your elbow
- Feel the stretch and hold for 10 seconds
- Now turn your hand back over so your palm faces downwards, feel the stretch and hold for 10 seconds
Support your elbow on a table with your wrist straight and fingers pointing towards the ceiling
- Bend your fingers into your palm as tightly as you can
- Hold the stretch 10 seconds
- Now stretch your fingers as wide as you can
- Hold the stretch for 10 seconds
- This exercise you will have practiced whilst in the splint but it is important to do out of the splint as you may now gain further
All photos with kind permission of ©Physiotec™
Exercises should be practiced 10 times, 3 to 4 times per day. Initially you will be stretching the muscles around the wrist that have become stiff whilst you have been in a cast/splint. As a result, you may experience more discomfort when you start the exercises, however this is normal and does not mean you should stop. If your symptoms remain worse for more than two hours after the exercises, then you should decrease the number of each exercise that you do and build up again slowly.
After the cast/splint has been removed, when should I start increasing my activity?
Repetitive wrist and hand movements and lifting objects heavier than a cup of water should be avoided to begin with. However, as your movement improves and pain reduces, little by little you can increase the amount of weight that you are able to lift. Progressing quickly from lifting a cup of water to a heavy shopping bag for example would not be advisable, as is likely to result in overloading of the soft tissue and could consequently lead to delayed recovery.
If you participate in an active hobby then it is advisable that you do not return to this until you have full strength and full range of movement.
If you play a sport, you can practice sports specific activities; like throwing or catching. Build up these exercises gradually from around 6 weeks, in order to help regain strength and flexibility, before returning to full training sessions and competition.
Do I require a follow up?
Do I need to be referred to Physiotherapy?
If the fracture clinic team feel you need to be seen by the Physiotherapy team, you will be directly referred to physiotherapy from fracture clinic and if this is the case, you will have been informed of this in your telephone call following your Virtual Fracture Clinic appointment. You will receive a letter or phone call to book this appointment within 2 weeks of the referral being made.
If you have not received one within this time, please contact the physiotherapy department on 01482 674880 between the hours 8.00am – 4.00pm Monday to Friday. If there is no answer please leave a message and your call will be returned with the same working day.
Most of the time however, a referral to Physiotherapy is not needed, but if you have any concerns, are unable to follow the advice in this leaflet, or if you still have reduced movement, strength or function, East Riding GP patients can contact the East Riding MSK Physiotherapy service on 01377 208300. Alternatively you can complete a self referral form on https://www.chcpmsk.org.uk/self-referral-form-introduction
Hull GP patients should call the fracture clinic number in the information below.
Do I need a Fracture Clinic follow up appointment?
A follow up appointment for fracture clinic is not required and you have been placed on a Patient Initiated Follow Up (PIFU) pathway. This means you will not have another appointment to be seen in fracture clinic.
If, however you have any problems or further queries relating to this injury within the next six weeks, you can contact us on 01482 674378 during clinic hours 9.00am – 4.30pm Monday to Friday. Please do not choose an option and when prompted leave a message if there is no answer and we will aim to get back to you within the same working day. If you have not needed to contact us in the six weeks after your injury, you will be discharged and should seek advice from your GP.
This leaflet was produced by the Orthopaedic Department, Hull University Teaching Hospitals NHS Trust and will be reviewed in May 2025
General Advice and Consent
Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.
Consent to treatment
Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.
The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:
- you must be able to give your consent
- you must be given enough information to enable you to make a decision
- you must be acting under your own free will and not under the strong influence of another person
Information about you
We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.
We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.
Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.
If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.
