What it is

Open reduction and internal fixation restore alignment and stability after fractures of the distal radius or scaphoid. Plates and screws hold the distal radius; headless screws are commonly used to fix the scaphoid. The goal is stable fixation for early motion and reliable strength.

Rehabilitation prevents stiffness, restores forearm rotation, and rebuilds load tolerance for work and sport.

What happens when it occurs

Fragments are aligned and fixed through an open approach. Early controlled motion protects the repair while preventing adhesions from forming. Progression depends on fracture pattern, fixation strength, and bone quality.

Common causes and risk factors before surgery

  • Falls onto an outstretched hand
  • Cycling incidents and board sports
  • Osteoporosis or low bone density in older adults

Who is most affected

All ages after falls; distal radius fractures are frequent in older women. Scaphoid fractures are common in younger adults after sports or cycling.

Typical symptoms before surgery

  • Pain, swelling, and deformity for distal radius patterns
  • Tenderness in the anatomical snuffbox for scaphoid fractures
  • Loss of grip and forearm rotation

When to seek care

Immediately after injury, for imaging and planning. Early fixation improves alignment and function.

How we diagnose

X‑rays define fracture pattern; CT is used for articular involvement or scaphoid planning. Neurovascular status is assessed and monitored.

Management

  • Protection with a splint or cast, then controlled motion by protocol
  • Scar and swelling care
  • Range for wrist flexion, extension and forearm rotation
  • Progressive strength for grip, forearm, and shoulder
  • Task practice and staged return to work and sport

Rehabilitation milestones

Phase 1 weeks 0–2: protect fixation, hand and shoulder activity, assisted range as allowed.

Phase 2 weeks 2–6: increase range, light isometrics and endurance without stressing fixation.

Phase 3 weeks 6–12: active strength, grip endurance, functional drills.

Phase 4 months 3–6: work and sport tasks by criteria.

Readiness to progress

  • Pain stable and wounds healthy
  • Radiographic healing as advised
  • Strength and range targets met without next‑day flare

Long-term care

  • Maintain mobility habits for rotation and extension
  • Build strength for carrying, pushing, and pulling
  • Manage bone health where relevant

Australia snapshot

  • Frequent after falls and cycling incidents
  • Public and private centres offer fixation and rehabilitation
  • Return to work is common with a staged plan

Latest insights

Forearm rotation returns best with early safe motion.

Strength grows on the back of steady range gains and swelling control.

Frequently Asked Questions

Sometimes, it can irritate the healing process and continue to irritate after the wound has healed. Once the plate has done its job, if it does irritate the wrist or hand, it can be removed. It is not always required.

After radiographic healing and strength targets are met, begin with light tasks.

Often, briefly for protection, then a removable brace as motion begins.