Physiotherapy Exercises following a Broken Wrist (Scaphoid Fracture)

Stuart, in Norwich, England asks:

"I broke my scaphoid bone. It's healed but I still dont have full mobility in it. Could you advise on any physio exercises I can do."

David Wales, Clinical Specialist Physiotherapist responds:

"The Scaphoid bone is the most commonly fractured of the eight wrist bones that make up the wrist complex. These fractures occur relatively commonly following a fall onto an outstretched hand. Because of the poor blood supply to the Scaphoid, there are often problems with fracture healing, but other complications related to a lack of mobility and residual stiffness are also quite common.

"The traditional management of Scaphoid fractures is to immobilise the wrist using a plaster cast. As with all cast immobilisation this produces short term stiffness around the wrist. In most patients this stiffness can benefit greatly from physiotherapy treatment such as massage, moblisation of surrounding joints and exercise, although symptoms remain in some wrists.

"Recent advances in surgical techniques have changed the management of Scaphoid fractures. In patients where conservative treatment using immobilisation has failed to produce a healed fracture, where the fracture fragments are displaced (not in close proximity) or where the patient's occupational demands require a more swift, certain outcome, then surgical treatment is indicated.

"Conventional open surgery involves a small screw being inserted into the Scaphoid in order to unite the fracture fragments. This may be followed by 6 weeks of wrist immobilisation in a cast or immediate mobilisation, depending on the preference of the surgeon.

"New surgical techniques using wrist arthroscopy are now becoming more popular. The arthroscope allows the surgeon to inspect the bones and soft tissues of the wrist, giving more useful information than x-ray films. Arthroscopy has an advantage over 'open' surgery in that it is less invasive and there is less associated soft tissue damage. This means the duration of rehabilitation is reduced.

"Recent studies have reported the findings in patients who have undergone arthroscopic surgery for the treatment of Scaphoid fractures. These findings have shown that more than a third of patients suffered wrist ligament and cartilage injuries, in addition to their Scaphoid fractures. These injuries have been described as 'Combined Wrist Injuries' (Wong et al, 2005) and would explain why wrist symptoms continue in patients who have had a Scaphoid fracture that has been shown to have healed on x-ray.

"Without arthroscopic surgery it may not be possible to diagnose Combined Wrist Injuries, even with investigations such as MRI. Once found, management of these injuries is dependent upon exactly which soft tissue is involved. Torn ligaments can be re-attached to the wrist bones using surgical wire. This is usually followed by immobilisation in a plaster cast for six to eight weeks, at which point the wires are removed and physiotherapy treatment begins.

"Another common finding in Combined Wrist Injuries was damage to the fibro-cartilage disc, which is known as the Triangular Fibro Cartilage Complex (TFCC). The TFCC sits between the Ulna (one of the forearm bones) and the bones of the wrist area and its function is to increase the stability of the wrist. Damage to the TFCC can be repaired with arthroscopic surgery, where the articular disc is either repaired using sutures or partially shaved off.

"If you are still experiencing symptoms in your wrist then you should return to your orthopaedic doctor for their opinion. If the Scaphoid is fully healed then it may be possible that you have a Combined Wrist Injury, and soft tissue lesions are producing your symptoms. Degeneration is also relatively common following Scaphoid fractures, so your doctor will have to review this.

"If you do have a Combined Wrist Injury then the latest evidence suggests that arthroscopic surgery is the most effective treatment in the long term. Physiotherapy treatments, such as hot wax baths and mobilisations may be effective in relieving the symptoms of wrist pain and stiffness in the short term, but ultimately a surgical approach may be necessary."


Article published: 8th August 2005

Related Articles

Injury A to Z: Scaphoid Fracture >

Further Reading

  1. Bernstein, M.A., et al (2004) A comparison of combined arthroscopic triangular fibrocartilage complex debridement and arthroscopic wafer distal ulna resection versus arthroscopic triangular fibrocartilage complex debridement and ulnar shortening osteotomy for ulnocarpal abutment syndrome  Arthroscopy: The Journal of Arthroscopic & Related Surgery Volume 20, Issue 4, Pages 392-401
  2. Conca, M., Conca, R., and Dalla Pria, A. (2004) Preliminary experience of fully arthroscopic repair of triangular fibrocartilage complex Arthroscopy: The Journal of Arthroscopic & Related Surgery Volume 20, Issue 7Pages e79-e82
  3. Garcia de Lucas, F., et al (2003) Evaluation of the 42 TFCC tears by arthroscopy and MRI  The Journal of Hand Surgery Volume 28, Supplement 1, Page 48
  4. Jui-Tien Shih, Hung-Maan Lee, Yao-Tung Hou and Chuan-Ming Tan (2005) Results of Arthroscopic Reduction and Percutaneous Fixation for Acute Displaced Scaphoid Fractures  Arthroscopy: The Journal of Arthroscopic & Related Surgery Volume 21, Issue 5, Pages 620-626
  5. Wong, T.C., Yip, T.H., and Wu, W.C. (2005) Carpal ligament injuries with acute scaphoid fractures – a combined wrist injury  The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand Volume 30, Issue 4, Pages 415-418




Row View Grid View

medi Epicomed Silver

£69.99 inc VAT


More Details

medi Epicomed Silver has a rating of 5.0 stars from 1 reviews (1 review)

Availability: In Stock

Quantity

PhysioRoom.com Hand Grip Exerciser

£1.49 inc VAT Was £6.99 Save £5.50 (79%)

Durable handles and resistance springs demonstrates the high quality of the Hand Grip Exerciser by PhysioRoom.com. Use it to strengthen muscles in the hands, arms and wrists.
More Details

PhysioRoom.com Hand Grip Exerciser has a rating of 5.0 stars from 1 reviews (1 review)

Availability: In Stock

Quantity

PhysioRoom.com Hand Grip Strengthener With Foam Handle

£2.49 inc VAT Was £4.99 Save £2.50 (50%)

The hand grip strengthener features a foam handle to ensure of a comfortable grip. The hand grip strengthener has durable foam handles and resistance springs to increase the strength of the forearm and the hand grip.
More Details

PhysioRoom.com Hand Grip Strengthener With Foam Handle has a rating of 5.0 stars from 1 reviews (1 review)

Availability: In Stock

Quantity

PhysioRoom.com x2 Hand Grips With Foam Handles

£5.49 inc VAT

The x2 hand grips with foam handles ensure of a totally comfortable grip. The hand grips with foam handles feature resistance springs which help to increase the strength of the forearm and hand grip.
More Details

PhysioRoom.com x2 Hand Grips With Foam Handles has a rating of 5.0 stars from 1 reviews (1 review)

Availability: In Stock

Quantity

Fitness Mad Reaction Ball

£3.99 inc VAT


More Details

Availability: In Stock

Quantity

PhysioRoom.com Instant Ice Pack

From £0.29 inc VAT     1+ £2.03 each
    6+ £1.29 each (Save 36%)
  12+ £0.79 each (Save 61%)
  24+ £0.49 each (Save 76%)
  50+ £0.29 each (Save 86%)

A mouldable pack that becomes an instant, single use ice pack, without the need for refrigeration.
More Details

PhysioRoom.com Instant Ice Pack has a rating of 5.0 stars from 9 reviews (9 reviews)

Availability: In Stock

Quantity

Physicool Cooling Bandage (10cm x 2m) - Ideal for wrists, ankles, elbows

£9.99 inc VAT

Physicool is an innovative and uniquely designed reusable strapping that combines the healing characteristics of cold therapy with the support qualities of a compression bandage. Differing from the more traditional treatments currently available, Physicool works by drawing heat away from the body to provide an instant long-lasting cooling effect which can be utilised for extended periods.
More Details

Physicool Cooling Bandage (10cm x 2m) - Ideal for wrists, ankles, elbows has a rating of 5.0 stars from 2 reviews (2 reviews)

Availability: In Stock

Quantity

Physicool Combination Pack

£13.99 inc VAT Was £14.99 Save £1.00 (7%)

The Physicool combination pack supplies you with one specially formulated cooling bandage and one bottle of recharging coolant which will rejuvenate and refresh the dressing. Small and compact this kit is ideal for wrist, elbow and ankle injuries providing between 2-3 hours of cold therapy and compression.
More Details

Physicool Combination Pack has a rating of 5.0 stars from 2 reviews (2 reviews)

Availability: In Stock

Quantity

Physicool Cooling Bandage (12cm x 3m) - Ideal for knees, legs, shoulders, back

£12.99 inc VAT

Physicool is a new and unique way to instantly apply cold therapy whilst on the move, this portable and reusable compression bandage is applied quickly and easily allowing the healing process to begin immediately. By taking heat away from the body Pysicool have developed a product which differs from move traditional methods meaning it can be used for longer periods.
More Details

Physicool Cooling Bandage (12cm x 3m) - Ideal for knees, legs, shoulders, back has a rating of 5.0 stars from 3 reviews (3 reviews)

Availability: In Stock

Quantity

Vulkan Neoprene Wrist Strap

£11.99 inc VAT Was £16.99 Save £5.00 (29%)

A high quality neoprene wrist support, ideal for use during sports. It features an adjustable Velcro strap to provide custom support and wrist protection. It doesn't cover the hand, making it ideal for ball handling sports.
More Details

Availability: In Stock

Quantity

PhysioRoom.com Wrist Brace With Thumb Splint

£14.99 inc VAT Was £29.99 Save £15.00 (50%)

Adjustable, lightweight and removable wrist/thumb brace that can also be used as a protective cast. Protects the wrist and thumb following fractures and sprains while permitting full finger function.
More Details

PhysioRoom.com Wrist Brace With Thumb Splint has a rating of 5.0 stars from 12 reviews (12 reviews)

Availability: In Stock

Quantity

PhysioRoom.com Elite Knitted Snug Series Wrist Support with Adjustable Strap

£14.99 inc VAT Was £29.99 Save £15.00 (50%)

The Snug wrist support with aluminium stay and gel pad is a lightweight support which helps to relieve wrist pain. The Snug wrist support ensures of total comfort by providing equal compression.
More Details

PhysioRoom.com Elite Knitted Snug Series Wrist Support with Adjustable Strap has a rating of 5.0 stars from 10 reviews (10 reviews)

Availability: In Stock

Quantity

PhysioRoom.com Elite Adjustable Wrist Wrap

£3.99 inc VAT Was £14.99 Save £11.00 (73%)

The Elite adjustable wrist wrap provides firm, adjustable support and helps to relieve pain caused by an injury to the wrist as well as reducing the risk of a future injury.
More Details

PhysioRoom.com Elite Adjustable Wrist Wrap has a rating of 4.5 stars from 4 reviews (4 reviews)

Availability: In Stock

Quantity

Donjoy Respiform Wrist & Thumb

£29.99 inc VAT

The Donjoy Respiform Wrist and Thumb support has been manufactured from a new 'flexy' material which conforms neatly to the anatomy creating a snug streamlined fit. With a plush padded interior for added comfort the unique velour fabric provides an excellent non-slip option which is suitable for use over extended periods.
More Details

Availability: Out Of Stock (Awaiting Due Date)

More Details

Donjoy Respiform Wrist

£19.99 inc VAT

The Donjoy Respiform Wrist support is a post-injury and post-surgery brace designed to immobilise the hand and wrist.
More Details

Donjoy Respiform Wrist has a rating of 5.0 stars from 1 reviews (1 review)

Availability: Selected options in stock

Quantity

PSB Wrist Support

£19.99 inc VAT

The PSB Wrist Support has been designed using the latest production techniques and industry fabrics to create a high quality easy-to-apply brace. Working with a team of professional athletes, technicians have created a product which is able to prevent excess or abnormal wrist movement without compromise allowing you the freedom to compete in the sports you enjoy.
More Details

PSB Wrist Support has a rating of 5.0 stars from 2 reviews (2 reviews)

Availability: In Stock

Quantity

medi Manumed T Wrist Brace

£54.90 inc VAT


More Details

Availability: Selected options in stock

Quantity

medi Manumed Wrist Brace

£39.99 inc VAT Was £49.99 Save £10.00 (20%)


More Details

Availability: Selected options in stock

Quantity

medi Manumed Active

£49.99 inc VAT


More Details

medi Manumed Active has a rating of 5.0 stars from 1 reviews (1 review)

Availability: In Stock

Quantity

Rehband Blue Line Wrist Support

£26.99 inc VAT Was £29.99 Save £3.00 (10%)


More Details

Availability: In Stock

Quantity

Mentholatum Deep Relief Gel

£6.99 inc VAT Was £7.99 Save £1.00 (13%)

Deep Relief dual action gel with ibuprofen is a clear, non-sticky and non-greasy gel with a mild, pleasant menthol fragrance.
More Details

Mentholatum Deep Relief Gel has a rating of 5.0 stars from 2 reviews (2 reviews)

Availability: In Stock

Quantity

Empi Direct TENS

£49.99 inc VAT

The Empi Direct TENS machine (transcutaneous electrical nerve stimulator) is a compact dual channel handheld device which utilises a range of nerve stimulation programmes to aid in the treatment and management of chronic and acute conditions.
More Details

Empi Direct TENS has a rating of 5.0 stars from 1 reviews (1 review)

Availability: In Stock

Quantity

Mueller Wrist Brace (with splint)

£18.99 inc VAT Was £21.99 Save £3.00 (14%)

Perfect for providing support following a broken or sprained wrist. This lightweight wrist brace features an aluminium splint and adjustable Velcro straps.
More Details

Mueller Wrist Brace (with splint) has a rating of 5.0 stars from 1 reviews (1 review)

Availability: In Stock

Quantity

Tenscare Touch TENS Machine

£30.99 inc VAT Was £41.99 Save £11.00 (26%)

Easy to use dual channel digital TENS machine for effective pain relief featuring seven preset programmes. Just stick on the electrodes, press a button and this simple-to-use TENS machine will use an electrical current to reduce your pain.
More Details

Tenscare Touch TENS Machine has a rating of 5.0 stars from 6 reviews (6 reviews)

Availability: In Stock

Quantity

Tenscare Sports TENS 2

£79.99 inc VAT

Extremely safe and easy-to-use, the TensCare Sport TENS 2 machine has a number of practical functions.
More Details

Tenscare Sports TENS 2 has a rating of 5.0 stars from 1 reviews (1 review)

Availability: Out Of Stock (Awaiting Due Date)

More Details

Aircast Hand & Wrist Cryo/Cuff with Cooler

£108.86 inc VAT Was £147.99 Save £39.13 (26%)

Ultimate hand & wrist ice therapy; provides 6 hours continuous cold and compression to minimise bleeding, swelling and pain.
More Details

Availability: Out Of Stock (Due 29-04-2015)

More Details

Aircast A2 Wrist Brace with Thumb Spica

£21.99 inc VAT

Adjustable, lightweight and removable wrist/thumb brace that can also be used as a protective cast. Protects the wrist and thumb following fractures and sprains while permitting full finger function.
More Details

Aircast A2 Wrist Brace with Thumb Spica has a rating of 5.0 stars from 10 reviews (10 reviews)

Availability: In Stock

Quantity

Aircast StabilAir Wrist Orthosis

£59.99 inc VAT

A lightweight, water resistant brace for use following a broken wrist or wrist surgery.
More Details

Aircast StabilAir Wrist Orthosis has a rating of 5.0 stars from 4 reviews (4 reviews)

Availability: In Stock

Quantity

Row View Grid View