Wrist & Distal Radius Fracture Postoperative Protocol

The Reno Orthopedic Center Fracture and Trauma Surgeons have created postoperative fracture protocols for our patients. These are based on the latest orthopedic science and literature in order to give patients the most up to date care. Their content is designed to explain what type of injury was sustained, the type of surgery that was done and simple instructions for weight bearing, wound care, physical therapy, medicine and diet issues. Patients will hear similar information in each postoperative visit but it is easy to forget what is said. The following protocol is designed to help patients in their healing with a single resource for frequently asked questions.

What Was Broken

You broke your wrist which is called the distal radius.

What Was Done in Surgery 

Your wrist was fixed with a titanium plate and screws. The surgery often requires 6-10 screws depending on the fracture pattern.

Follow Up Appointment 

You should see your surgeon or his physician assistant 10-14 days after surgery. Usually, this appointment is made when you schedule surgery. If you do not have one, please call the office to schedule at 775-786-3040 as soon as you can. You will be seen at 2 weeks, 6 weeks and 3 months from surgery where the provider will examine you and x-rays will be taken to follow bone healing. 

Splint or Cast Care 

Your wound was closed with sutures and sterile dressings and a splint or cast was placed to protect your incision and bone repair until your first postoperative visit in clinic. It was placed under sterile conditions in operating room. Please do not remove it. This will increase your risk of infection, wound healing issues and bone displacement. At your first clinic visit we will give you a removable wrist brace. 

 Showering 

You may shower immediately after surgery. Splint or cast can be covered with a bag or cast cover available at our ROC Shop. If it gets soiled, too wet, or too dry please come into the clinic earlier than your first postoperative visit to get it replaced by one of our trained cast technicians. 

Pain Control 

You have been given a prescription for narcotic pain medication. You can take 1-2 pills every 4-6 hours. It is ok to take anti-inflammatory medicine like Motrin (ibuprofen) or Tylenol (acetaminophen) as well. Do not take more than 4 grams of Tylenol a day or it can hurt your internal organs. The orthopedic surgeon by law can only give you narcotic pain medicine for 2 weeks after surgery. This must be prescribed in only a 5 day supply each time. If you already get narcotics from your primary care doctor or pain management doctor, the orthopedic surgeon cannot write you a separate prescription. If you need prolonged narcotics, we can refer you to a pain management specialist. If these rules are bent, the orthopedic surgeon can lose his medical license, insurance contracts and be unable to care for other patients like you. Please respect these regulations.  

Marijuana 

THC and CBD products can be helpful for postoperative pain and decrease the amount of narcotics you need. In Nevada, marijuana is legal, and you do not need a doctor’s prescription to get it. THC use avoids the constipation and addiction potential associated with narcotic use. Edible use avoids the other risks associated with smoke inhalation and has more controllable dosing. 

Diet 

Eat a well-balanced diet. If you are diabetic keep your blood sugars well controlled. High blood sugar can put you at risk for infection, wound complications and the bone not healing (nonunion).  

Sutures/Staples 

Your wound has been closed with sutures or staples depending on your surgeon’s preference. They will be removed at your first postoperative follow up appointment 10-14 days after surgery.  

Weight Bearing 

You are given a sling for comfort after surgery. You do not need to wear it if you do not want to. You should not lift more than a cup of coffee for the first 6 weeks after surgery. After that time if x-rays show good healing bone you can return to lifting, biking, motor cross, skiing, manual labor, etc. 

Physical Therapy 

Most patients with wrist fractures do not need therapy. Because you can use your wrist 10 days after surgery. We will show you exercises you can do on your own at your first postoperative clinic visit. 

Return to Work 

Patients can usually return to a desk job or light duty after a few days. Return without restriction to jobs that require heavy lifting or manual labor. Usually takes about 6-8 weeks 

Driving 

You may drive the day after surgery. You should not drive a car if you are still taking narcotic pain medication. 

Hardware Removal 

The metal plate and screws usually stay in for life and are not routinely removed. However, if the metal becomes infected or is painful 1 year after surgery it can be removed. 

Healing Time 

The wrist or distal radius fracture treated with surgery takes about 3 months to heal completely. If too much activity is done too early the metal plate can break before bone is healed. If the crack went into the joint surface and bones shift with early activity you can place yourself at risk for post traumatic arthritis. Younger patients heal slightly faster and older patients or those with diabetes take slightly longer to heal.