Elbow and Wrist Fracture Fixation Physiotherapy in Singapore

Elbow and wrist fracture surgery rehabilitation at a glance

What makes elbow and wrist fracture rehabilitation different?

Elbow and wrist fracture fixation holds the broken bone with a plate, screws or wires, so the joint can move long before the bone has fully healed. Rehabilitation is a race against stiffness: the fingers, wrist and elbow stiffen quickly when they are kept still, and the elbow in particular is slow to give back movement once it is lost.

Bone takes about six weeks to heal and roughly another six weeks to become nearly as strong as before, according to Imperial College Healthcare NHS Trust. In that time the plan protects the fixation from heavy loads while keeping the fingers, wrist, elbow and shoulder moving. Singapore General Hospital asks people to keep the operated hand above heart level and to move the fingers often to prevent stiffness (SGH patient leaflet).

Our post-surgery physiotherapy page sets out the general stages of recovery, your first appointment and the warning signs after any operation. This page covers the fixed elbow and wrist. If your fracture was treated in a cast without surgery, or you have a sprain, see our wrist strain and sprain page or elbow pain page instead.

Which operation did you have, and how does it change rehabilitation?

The three common operations are a plate or wires for a broken wrist (distal radius), fixation or replacement of the radial head at the elbow, and wires or a plate for the olecranon, the point of the elbow. Each one has its own early limits and its own lingering problem.

Other fractures, such as the lower end of the upper arm bone (distal humerus), the scaphoid or the fingers, follow their own rules. Bring your operation note and we will work from it.

Moving the wrist early after a plate: what does the evidence show?

After a stable volar plate, starting wrist movement straight away and waiting about two weeks in a splint appear to give similar results. The timing matters less than many people fear, and your surgeon decides which approach suits your fracture.

A randomised trial of 48 people published in Scientific Reports in 2022 let one group move the wrist immediately after volar plate fixation and kept the other in a splint for two weeks. Function, pain, grip and wrist movement improved in both groups with no significant difference at any point, and X-ray results and complications did not differ.

The wider evidence is thin. A Cochrane review of 26 trials with 1,269 people (2015) found not enough evidence to say which form of rehabilitation works better than another after a broken wrist. After plate fixation, low-quality evidence favoured a structured home exercise programme with instruction over routine therapy sessions, and accelerated rehabilitation gave a short-term benefit that did not last.

Guidelines say much the same. The American Academy of Orthopaedic Surgeons advised in 2009 that early wrist motion is not routinely needed after stable fixation, and its 2020 guideline found the evidence comparing home exercise with supervised therapy inconsistent.

What this means in practice

• Most people do well with a clear home programme and a few well-timed sessions to check and progress it.
• More supervised help makes sense when the fingers will not make a full fist, the wrist is not loosening, grip is lagging or your job needs a strong hand.
• In Singapore's public hospitals, wrist rehabilitation after surgery is often led by hand occupational therapists (SGH, NUH). If you are already seeing one, we can work alongside that plan rather than duplicate it.

Elbow and wrist fracture surgery recovery: what to expect by week

A common pattern is light use of the hand for about six weeks, driving from about six to eight weeks, heavy lifting and hard gripping from about three months, and a hand or elbow that feels close to normal by four to six months. The table combines Singapore and NHS advice, which differs between hospitals.

Sources include Singapore General Hospital, Imperial College Healthcare, Swansea Bay, University Hospital Southampton, University Hospitals Coventry and Warwickshire, Royal Berkshire, Wrightington, Wigan and Leigh and Royal United Hospitals Bath. Your surgeon's instructions take priority over any timing here.

Why are the fingers, wrist and elbow stiff and weak, and for how long?

Stiffness is the main problem after elbow and wrist fracture surgery, and it eases over months. At the wrist it shows in a weak grip and a tight fist; at the elbow it usually shows as an arm that will not fully straighten.

About 5% of people lose elbow movement after an injury, and loss of straightening is commoner than loss of bending, according to a StatPearls review of the stiff elbow. Most everyday tasks need the elbow to move between about 30 and 130 degrees, so a few degrees short of straight is often livable, while a larger loss affects reaching and carrying. The same review notes that extra bone can form around the joint (heterotopic ossification) in up to 20% of elbow fractures and complex dislocations.

At the wrist, a UHCW NHS leaflet says the joint may stay tender for two to three months and that feeling reasonably normal can take four to six months, with improvement for up to 18 months. Grip strength is often the last thing to come back.

What helps

• Keep the hand raised in the first two weeks, and move the fingers little and often.
• Practise the movements you were shown several times a day. Short, frequent sessions beat one long one.
• At the elbow, work on straightening and on turning the palm up as well as bending. These are the movements most likely to be lost.
• Use the hand for light daily tasks as soon as you are allowed, such as eating with chopsticks, typing and holding your phone. Leave carrying shopping bags and heavy pots until your surgeon clears it.
• Massage the scar once it has healed, as Swansea Bay advises, to keep the skin and tendons gliding.

Driving, work and sport after elbow or wrist fracture surgery

Most people can drive from about six to eight weeks, return to desk work within the first few weeks if they avoid lifting, and go back to heavy work and contact or racket sports from about three to six months.

For the wrist, a University Hospital Southampton leaflet says not to drive until at least six to eight weeks after surgery, and Swansea Bay says driving can be considered from six weeks if you feel safe and confident. For the elbow, Royal Berkshire gives six weeks as the earliest. Do not drive in a sling (RUH Bath). You need to hold the steering wheel firmly and turn it quickly, so check with your insurer as well.

Desk work can resume early with no lifting. Heavier duties wait for about three months in the Royal Berkshire elbow leaflet, and Swansea Bay advises avoiding heavy lifting, hard gripping and weight through the hand for three months after wrist surgery. That includes push-ups, yoga poses on the hands and pushing up from a chair.

For sport, Royal Berkshire allows breaststroke from eight weeks, freestyle and golf from about three months (but not the driving range) and contact and racket sports from three to six months. Badminton and tennis put repeated load through the wrist and forearm, so we use grip strength, movement and loading tests to decide, not the date alone.

Complications and hardware: what to watch for

Most elbows and wrists heal without trouble, but a few problems need prompt attention. The ones to know about are wound infection, nerve symptoms, pain out of proportion to the injury and metalwork that irritates.

• Fever of 38°C or higher, a red, smelly or leaking wound, severe pain not eased by your medicine, or a hand that turns cold, blue or numb: Singapore General Hospital advises going to its Emergency Department (SGH leaflet). Contact your own surgeon's team or emergency department straight away.
• Pins and needles or colour change in the fingers when the arm is bandaged: loosen any compression sleeve and speak to your therapist, as WWL NHS advises.
• Pain, swelling, colour or temperature changes that seem far out of proportion: tell your surgeon. Complex regional pain syndrome is uncommon, recorded in 0.31% of people within a year of wrist fracture surgery in a Danish register study of over 200,000 people (2026).
• A plate that rubs or irritates a tendon at the wrist: removal is not routine. In one US hospital, 33 volar plates were removed out of about 1,100 fitted over six years, most often for pain or tendon irritation.
• Wires at the point of the elbow often bother people when leaning on the arm. In a Danish study of 55 people (2000) with tension band wiring of the olecranon, 72% had a second operation, mostly to remove wires that were causing symptoms. Newer plates may differ.
• Calf pain, chest pain or breathlessness: see the warning signs on our post-surgery page.

How we run elbow and wrist fracture rehabilitation at Benchmark Physio

We start from your operation note, follow your surgeon's rules on splints and lifting, and rebuild movement, grip and arm strength step by step.

Our lead physiotherapist holds APA Titled status and trained as an Exercise Scientist, so graded loading, from the first light grip to lifting and racket sport, is part of our everyday work.

Frequently asked questions about elbow and wrist fracture surgery rehabilitation

Related services

• Post-surgery physiotherapy
• Elbow pain
• Wrist strain and sprain
• Tennis and golfer's elbow
• Sports physiotherapy
• Home physiotherapy
• Online physiotherapy

Sources

The ranges and figures on this page come from the hospital guidance, studies and guidelines below. Protocols differ between surgeons and hospitals, so your own instructions take priority. Last reviewed November 2026.

1. Distal radius fracture surgery: patient information. Singapore General Hospital, Department of Hand and Reconstructive Microsurgery
2. Hand and wrist fractures. National University Hospital, Singapore
3. Fractured wrist: after surgery. Imperial College Healthcare NHS Trust, Hand Therapy, 2018
4. Open reduction internal fixation (ORIF) of the wrist. Swansea Bay University Health Board
5. Wrist fracture advice after an open reduction and internal fixation (ORIF). University Hospital Southampton NHS Foundation Trust, 2023
6. Fractured wrist needing surgery. University Hospitals Coventry and Warwickshire NHS Trust, 2025
7. Radial head ORIF: advice and exercises. Royal Berkshire NHS Foundation Trust, 2026
8. Olecranon fracture fixation surgery: advice and exercises. Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust
9. Advice after breaking your radial head or neck (elbow). Royal United Hospitals Bath NHS Foundation Trust, 2025
10. Laohaprasitiporn P and others. Comparative clinical and radiographic outcomes between early and delayed wrist mobilization after volar fixed-angle plate fixation of distal radius fracture. Scientific Reports, 2022
11. Handoll HHG, Elliott J. Rehabilitation for distal radial fractures in adults. Cochrane Database of Systematic Reviews, 2015
12. The treatment of distal radius fractures: guideline and evidence report. American Academy of Orthopaedic Surgeons, 2009
13. Management of distal radius fractures: clinical practice guideline. American Academy of Orthopaedic Surgeons, 2020
14. Stiff elbow. StatPearls
15. Melbye P and others. Incidence proportion of complex regional pain syndrome (CRPS) after distal radius fracture: a population-based register study. Acta Orthopaedica, 2026
16. Snoddy MC and others. Incidence and reasons for hardware removal following operative fixation of distal radius fractures. Journal of Hand Surgery, 2015
17. Romero JM, Miran A, Jensen CH. Complications and re-operation rate after tension-band wiring of olecranon fractures. Journal of Orthopaedic Science, 2000