Phase 1: Immediate Post-Operative (0–2 Weeks)

• Goals:
  • Protect the surgical site and allow initial healing.
  • Control pain and swelling.
  • Begin gentle range of motion (ROM) exercises as tolerated.
• Wound Care:
  • Keep the post operative splint clean and dry.
  • Monitor for signs of infection (redness, increased pain, fever).
• Immobilization:
  • Wrist splint or cast: Keep wrist in a neutral position for protection.
  • Elevation: Elevate the hand above the level of the heart to reduce swelling during the first 1-2 weeks.
  • Weight-bearing: Non-weight-bearing on the affected arm.
• Pain Management:
  • Medications: Use prescribed pain medications (Tylenol, celebrex, opioids, as needed).
  • Ice: Apply ice for 15–20 minutes every 2–3 hours to control swelling.
• Range of Motion (ROM):
  • Begin gentle, active ROM exercises for the fingers, elbow, and shoulder on the affected side.
• Physical Therapy:
  • Not required at this stage

Phase 2: Early Rehabilitation (2–6 Weeks)

• Goals:
  • Promote healing and restore mobility.
  • Start gentle wrist ROM as allowed by the surgeon.
• Splinting and Cast:
  • Sutures are typically removed at 10-14 days post-op.
  • Functional Brace: A removable brace may be worn for additional support after splint removal
• Range of Motion (ROM):
  • Active/passive wrist and forearm ROM exercises can begin, progressing gently under the supervision of a therapist or physician.
• Strengthening:
  • Light grip strengthening with a therapy ball or putty can be started at 4-6 weeks, depending on healing.
  • Gentle isometric exercises for wrist and forearm muscles may begin.
• Weight-Bearing:
  • Non-weight-bearing; no lifting with the affected hand > 3 lbs
• Pain Management:
  • Continue ice and elevate as needed.
  • Continue Tylenol use and wean narcotic medication
  • NO NSAID USE AFTER 2 WEEKS POST-OP
• Physical Therapy:
  • Start gentle stretching and active exercises for the wrist, forearm, and hand at the direction of the therapist.

Phase 3: Mid Rehabilitation (6–12 Weeks)

• Goals:
  • Regain full wrist ROM and begin strength training.
  • Return to activities of daily living (ADLs) with restrictions.
• ROM:
  • Full wrist ROM exercises may be introduced gradually, especially for extension and flexion, as tolerated.
  • Gentle weight-bearing exercises can begin under supervision.
• Strengthening:
  • Gradual resistance exercises can be initiated for wrist flexors, extensors, and forearm muscles.
  • Isometric strengthening may advance to more dynamic strengthening exercises.
• Weight-Bearing:
  • Gradual introduction of weight-bearing: Start with light activities (e.g., holding a glass or light object).
  • Avoid high-impact or heavy lifting until cleared by the physician.
• Pain Management:
  • Ice as necessary to manage inflammation or discomfort.
  • Tylenol for analgesic
• Physical Therapy:
  • Emphasize wrist strengthening, functional mobility, and grip strengthening.
  • Introduce proprioceptive exercises to improve wrist stability.

Phase 4: Late Rehabilitation (12+ Weeks)

• Goals:
  • Achieve full recovery of wrist function.
  • Return to normal activities and sport-specific movements.
• ROM:
  • Full range of motion in wrist, forearm, and hand.
  • Continue with exercises to maintain wrist flexibility.
• Strengthening:
  • Advanced strengthening exercises: Include resistive bands, light weights, and functional strength training.
  • Plyometric exercises can be introduced if the patient is an athlete and cleared by the surgeon.
• Weight-Bearing:
  • Gradual return to weight-bearing activities (e.g., lifting, pushing).
  • Increase load-bearing activities only as tolerated and with physician approval.
• Physical Therapy:
  • Return to sports/functional activities: Increase difficulty of therapy to match functional demands (e.g., grip, coordination).
  • Sport-specific exercises and functional movements can be resumed if appropriate.