Rehabilitation after fractures of the hand

Abstract

Rehabilitation after a hand fracture begins during the early phases of fracture healing and continues until skeletalintegrity and hand function are restored. The rehabilitation plan is tailored according to the stage of healing. The emphasis of therapy during the early reparative stage of healing is on edema control, pain management, preservation of motion at the uninvolved joints, protective splinting and positioning to prevent disruption of fracture healing, and to prevent joint contracture. The next phase of therapy begins when clinical healing is present and emphasizes the active mobilization of the joints immediately adjacent to the fracture that were incorporated in the cast or splint. Tendon gliding exercises are also stressed at this time to restore flexor and extensor tendon excursion. The final phase of therapy begins when the fracture is well healed. The focus of therapy at this time is the development of strength and hand function and the resumption of activities of daily living and work tasks. General rehabilitation techniques appropriate for all hand fractures include positioning and splinting, edema and pain control, joint and soft tissue mobilization techniques, and tendon gliding and strengthening exercises.