Rehabilitation After Distal Radius Fracture in Older Patients: A Practical Narrative Review for Clinicians
DOI:
https://doi.org/10.12775/JEHS.2026.93.72704Keywords
bone fracture, distal radius fracture, Rehabilitation, geriatric patients, wrist injury, Orthopedics, PhysiotherapyAbstract
BackgroundDistal radius fractures are common injuries in older patients and may temporarily reduce independence and hand function. Rehabilitation is usually included after both conservative and surgical treatment, although rehabilitation strategies remain variable in clinical practice.
AimThe aim of this narrative review was to summarize practical aspects of rehabilitation after distal radius fracture in elderly patients.
Material and MethodsLiterature indexed in PubMed, PEDro, and the Cochrane Library was reviewed in a non-systematic manner using clinically relevant orthopedic and rehabilitation publications related to wrist fracture recovery, physiotherapy, and geriatric rehabilitation.
ResultsThe literature supports gradual rehabilitation adapted to tolerance, frailty, baseline function, and ability to follow instructions. In uncomplicated fractures, a clear home program often restores useful hand function. Supervised physiotherapy is most valuable when stiffness, weakness, edema, pain, frailty-related limitation, or poor adherence delays recovery.
ConclusionsRecovery after distal radius fracture requires a plan built around practical hand use, independence, and patient tolerance rather than a generic protocol.
References
1. Nellans KW, Kowalski E, Chung KC. The epidemiology of distal radius fractures. Hand Clin. 2012;28(2):113-125. https://doi.org/10.1016/j.hcl.2012.02.001
2. MacIntyre NJ, Dewan N. Epidemiology of distal radius fractures and factors predicting risk and prognosis. J Hand Ther. 2016;29(2):136-145. https://doi.org/10.1016/j.jht.2016.03.003
3. Diaz-Garcia RJ, Chung KC. Common myths and evidence in the management of distal radius fractures. Hand Clin. 2012;28(2):127-133. https://doi.org/10.1016/j.hcl.2012.02.002
4. Lichtman DM, Bindra RR, Boyer MI, et al. Treatment of distal radius fractures. J Am Acad Orthop Surg. 2010;18(3):180-189. https://doi.org/10.5435/00124635-201003000-00007
5. Prylińska M, Gajos M, Cięszka K, Lipka M, Topka W, Kędziora-Kornatowska K. Physical rehabilitation after hip joint dislocation in the elderly. Journal of Education, Health and Sport. 2019;9(4):532-542. https://doi.org/10.5281/zenodo.2652419. Available from: https://apcz.umk.pl/JEHS/article/view/6856 [Accessed: 18.05.2026].
6. Handoll HHG, Elliott J. Rehabilitation for distal radial fractures in adults. Cochrane Database Syst Rev. 2015;(9):CD003324. https://doi.org/10.1002/14651858.CD003324.pub3
7. Chung KC, Shauver MJ, Birkmeyer JD. Trends in the United States in the treatment of distal radial fractures in the elderly. J Bone Joint Surg Am. 2009;91(8):1868-1873. https://doi.org/10.2106/JBJS.H.01297
8. Shauver MJ, Chung KC. Current and future national costs to Medicare for the treatment of distal radius fracture in the elderly. J Hand Surg Am. 2011;36(8):1282-1287. https://doi.org/10.1016/j.jhsa.2011.05.018
9. Bentohami A, Bosma J, Akkersdijk GJM, van Dijkman BA, Goslings JC, Schep NWL. Incidence and characteristics of distal radial fractures in an urban population in The Netherlands. Eur J Trauma Emerg Surg. 2014;40(3):357-361. https://doi.org/10.1007/s00068-013-0331-5
10. McQueen MM, Caspers J. Colles fracture: does the anatomical result affect the final function? J Bone Joint Surg Br. 1988;70(4):649-651. https://doi.org/10.1302/0301-620X.70B4.3403617
11. Mulders MAM, Fuhri Snethlage LJ, de Muinck Keizer RJO, Goslings JC, Schep NWL. Functional outcomes of distal radius fractures in the elderly: a systematic review. Injury. 2018;49(4):789-797. https://doi.org/10.1016/j.injury.2018.02.026
12. Arora R, Lutz M, Deml C, et al. Volar locking plate fixation versus nonoperative treatment in elderly patients with distal radius fractures. J Bone Joint Surg Am. 2011;93(23):2146-2153. https://doi.org/10.2106/JBJS.J.01597
13. Ochen Y, Peek J, van der Velde D, et al. Operative versus nonoperative treatment of distal radius fractures in adults. JAMA Netw Open. 2020;3(4):e203497. https://doi.org/10.1001/jamanetworkopen.2020.3497
14. American Academy of Orthopaedic Surgeons. Management of Distal Radius Fractures Clinical Practice Guideline. Rosemont, IL: AAOS; 2020. Available from: https://www.aaos.org/drfcpg [Accessed: 18.05.2026].
15. British Orthopaedic Association and British Society for Surgery of the Hand. Best practice for management of distal radial fractures (DRFs). London: BOA/BSSH; 2018. Available from: https://www.bssh.ac.uk/_userfiles/pages/files/professionals/Radius/Blue%20Book%20DRF%20Final%20Document.pdf [Accessed: 18.05.2026].
16. Valdes K. Effective interventions for distal radius fracture rehabilitation. J Hand Ther. 2015;28(2):165-167. https://doi.org/10.1016/j.jht.2015.01.008
17. Souer JS, Ring D. Wrist stiffness after distal radius fractures. Hand Clin. 2010;26(1):97-105. https://doi.org/10.1016/j.hcl.2009.08.007
18. Valdes K, Naughton N. Conservative interventions for treating distal radius fractures in adults. J Hand Ther. 2016;29(2):123-130. https://doi.org/10.1016/j.jht.2016.02.010
19. Quadlbauer S, Pezzei C, Jurkowitsch J, et al. Early rehabilitation of distal radius fractures stabilized by volar locking plate: a prospective randomized pilot study. Arch Orthop Trauma Surg. 2017;137(7):987-993. https://doi.org/10.1007/s00402-017-2693-1
20. Lozano-Calderon SA, Souer S, Mudgal C, Jupiter JB, Ring D. Wrist mobilization following volar plate fixation of fractures of the distal part of the radius. J Bone Joint Surg Am. 2008;90(6):1297-1304. https://doi.org/10.2106/JBJS.G.01314
21. Walenkamp MMJ, de Muinck Keizer RJO, Goslings JC, Vos LM, Rosenwasser MP, Schep NWL. Functional outcome in patients with unstable distal radius fractures. J Hand Surg Eur Vol. 2018;43(7):745-754. https://doi.org/10.1177/1753193418772983
22. MacDermid JC, Roth JH, Richards RS. Pain and disability reported in the year following a distal radius fracture: a cohort study. BMC Musculoskelet Disord. 2003;4:24. https://doi.org/10.1186/1471-2474-4-24
23. Valdes K, Naughton N, Algar L. Therapist-supervised hand therapy versus home therapy with therapist instruction following distal radius fracture. J Hand Ther. 2015;28(2):166-173. https://doi.org/10.1016/j.jht.2014.12.001
24. Maciel JS, Taylor NF, McIlveen C. A randomized clinical trial of activity-focused physiotherapy on patients with distal radius fractures. Arch Orthop Trauma Surg. 2005;125(8):515-520. https://doi.org/10.1007/s00402-005-0034-3
25. Wakefield AE, McQueen MM. The role of physiotherapy and clinical predictors of outcome after fracture of the distal radius. J Bone Joint Surg Br. 2000;82(7):972-976. https://doi.org/10.1302/0301-620X.82B7.10519
26. Krischak GD, Krasteva A, Schneider F, et al. Physiotherapy after volar plating of wrist fractures is effective using a home exercise program. Arch Phys Med Rehabil. 2009;90(4):537-544. https://doi.org/10.1016/j.apmr.2008.09.574
27. Bruder AM, Shields N, Dodd KJ, et al. Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review. J Physiother. 2017;63(4):205-220. https://doi.org/10.1016/j.jphys.2017.08.001
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Patryk Jakubiak, Katarzyna Jolanta Kuc, Katarzyna Zegadło, Maciej Dobrucki, Krzysztof Brzezicki, Mateusz Cieciora, Małgorzata Kawiorska, Julia Surowiec, Aleksandra Cieciora, Wiktoria Ruta Bełcikowska-Skowron

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 116
Number of citations: 0