Phase I: Protection and Early Recovery (0–2 Weeks)

Immobilisation:

• Postoperative bulky dressing and removable forearm splint for 2 weeks

• Splint removed for hygiene and prescribed exercises

Precautions:

• No lifting, carrying, pushing, pulling, or weight bearing through the operated upper limb

• Avoid forceful forearm pronation and supination

• Avoid forceful gripping

• Avoid impact activities

Therapy:

• Oedema management and elevation

• Active finger and thumb range of motion

• Active elbow flexion and extension

• Active shoulder range of motion

Criteria to Progress:

• Wound healed

• Pain controlled

• Swelling improving

• Functional finger and elbow motion

Phase II: Restore Motion (2–6 Weeks)

Immobilisation:

• Removable forearm splint for comfort and protection

• Wean from splint as comfort allows

Precautions:

• No lifting greater than a cup of tea

• Avoid forceful forearm rotation

• Avoid resisted pronation and supination

• Avoid impact activities

Therapy:

• Active and active-assisted forearm pronation and supination

• Wrist flexion and extension

• Progressive elbow range of motion

• Scar management

Criteria to Progress:

• Minimal swelling

• Functional forearm rotation

• Functional elbow and wrist ROM

• Tolerating light hand use

Phase III: Strength and Functional Recovery (6–12 Weeks)

Precautions:

• Gradually increase loading following evidence of fracture healing

• Avoid sudden heavy lifting

• Avoid repetitive rotational loading

Therapy:

• Progress to full forearm, wrist and elbow ROM

• Commence grip strengthening

• Wrist and forearm strengthening

• Functional upper limb strengthening

Criteria to Progress:

• Clinical and radiographic progression toward union

• Functional ROM restored

• Improved strength

• Minimal pain with strengthening

Phase IV: Return to Function and Endurance (3–6 Months)

Precautions:

• Gradual return to unrestricted loading

• Avoid abrupt progression into heavy rotational activities

Therapy:

• Progressive strengthening

• Functional rehabilitation

• Sport-specific rehabilitation as required

Criteria to Progress:

• Radiographic union achieved

• Near full forearm, wrist and elbow ROM

• Functional strength restored

• Return to unrestricted activity

General Recommendations

Work:

• Office and sedentary work may resume after approximately 1–2 weeks depending on comfort

• Manual labour is commonly delayed until approximately 8–12 weeks depending on fracture healing and occupational demands

Driving:

• It is important that you are medically fit to return to driving and liaise with your insurance provider to confirm liability requirements.

• Driving should only resume once you are no longer requiring a splint and can safely control the vehicle and perform emergency manoeuvres.

Sports and Leisure:

• Lower-limb activities may resume as comfort allows.

• Light hand use may commence from approximately 4–6 weeks.

• Progressive return to functional and gym activities from 8–12 weeks.

• Higher-demand forearm loading, racquet sports, or impact activities typically from 3–6 months or longer with full recovery and surgeon clearance.

Disclaimer: This protocol is intended as a general rehabilitation guide only. Rehabilitation progression should always be individualised and may be modified by A/Prof Ernstbrunner and the treating rehabilitation team based on the patient’s clinical progress, surgical findings, and individual circumstances.