This document, authored by Jared T. Lee, MD, outlines a rehabilitation plan for patients following a Distal Radius ORIF (Open Reduction Internal Fixation) procedure.
The document is divided into four phases:
- **Phase 1 (Weeks 0-2):** Focuses on protecting the repair, with the short arm splint left in place. Restrictions include being non-weight bearing. Therapeutic exercises include elbow and shoulder ROM, and finger ROM as tolerated.
- **Phase 2 (Weeks 3-6):** Transitions from a short arm splint to a short arm Exos brace, which must be worn at all times except for hygiene and OT. Restrictions include no lifting and no soaking the arm until 4 weeks post-op. Therapeutic exercises include scar massage/desensitization and gentle passive/active assisted ROM of the wrist and hand.
- **Phase 3 (Weeks 7-12):** Includes weaning to the brace for activity only and no lifting greater than 10 lbs. Therapeutic exercises include hand and wrist stretching, intrinsic hand strengthening, full passive/active assisted ROM of the wrist, light fine motor activities, and progressive resistance exercises/strengthening from week 8.
- **Phase 4 (Week 13 and onward):** Discharges all orthoses and focuses on the progression of functional activities and sport/recreational activity per the surgeon. Restrictions include progressing strengthening, returning to full sport/labor work at week 16, and avoiding sustained, heavy stress across the joint until 16 weeks. Therapeutic exercises include static and dynamic strengthening, maintaining ROM, advancing weight training, and a return to full activity progression.
The document also includes criteria for discharge: less than 10% strength deficit, limb similarity index of 90% or greater, 45/50 on biomechanical functional tests (if performed), and no pain or complaints of instability.