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

Immobilisation:

• Below-elbow backslab or splint

• Elevation encouraged to reduce oedema

Precautions:

• Avoid lifting, gripping, or weight-bearing through the wrist

• Protect wound and soft tissues

• Avoid forceful wrist motion

Therapy:

• Finger, thumb, elbow, and shoulder range of motion exercises

• Oedema control and wound care

• Gentle tendon gliding exercises

• Maintain mobility of uninvolved joints

Criteria to Progress:

• Healing wound

• Controlled pain and oedema

• Improving finger mobility

Phase II: Progressive Motion and Function (2–6 Weeks)

Immobilisation:

• Transition to removable wrist splint

• Wean splint progressively as directed

Precautions:

• Avoid heavy gripping and lifting

• Avoid impact loading

Therapy:

• Commence wrist active range of motion exercises

• Gentle passive motion as tolerated

• Forearm rotation exercises

• Continue oedema management

• Light functional hand use

Criteria to Progress:

• Improving wrist motion

• Minimal swelling

• Functional hand use

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

Precautions:

• Avoid sudden increases in loading

• Avoid repetitive heavy wrist loading early

Therapy:

• Progress wrist and forearm mobility

• Commence grip and forearm strengthening

• Functional and task-specific rehabilitation

• Gradual return to lifting and daily activities

Criteria to Progress:

• Functional range of motion

• Improving strength

• Minimal pain

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

Precautions:

• Gradual return to higher-demand activities

Therapy:

• Progressive strengthening and endurance training

• Functional rehabilitation

• Return to recreational activities as tolerated

• Criteria for Return to Activity

• Functional range of motion

• Good strength and endurance

• No significant pain or swelling

General Recommendations

Work:

• Desk-based work may resume after 1–2 weeks depending on comfort.

• Manual work typically from 8–12 weeks depending on recovery and job demands.

Driving:

• It is important that you are medically fit to return to driving and you feel safe to control the vehicle and take evasive action if needed.

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 wrist 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.