Distal Radius (wrist) Fracture with ORIF Surgery Recovery Timeline

Hey y'all,

Three weeks ago today I had a crash while off-roading with some buddies out in the desert on our adventure bikes. I made the mistake of following and keeping up with a former motocross/flat track racer, and I am not anywhere close in terms of skill in the dirt. So I hit the intersection of fucking around and finding out and ended up in a ditch with a broken right wrist and a somehow undamaged bike. The incident was 100% my fault and was due to a mix of being overly ambitious on dirt, and following too closely to my buddy and not being able to see through his dust, rookie mistake.

Went to an urgent care who splinted me, took x-rays, and I knew it was bad when the doctor came in with a CD to take to an orthopedic. Got in that Wednesday for 2 appointments for second opinions, and went with a surgeon who understood my background, hobbies, and how important range of mobility is. Had an ORIF surgery on 2/4/24 for a plate and 9 screws. Recovery immediately afterward hurt significantly more than actually breaking my wrist. I had a cast put on that was removed for a removable velcro brace last Thursday.

Aside from road racing, I am an avid mountain biker, rock climber, runner, and yoga practitioner and I'm in generally great health and fitness. Now that I am about 2.5 weeks post surgery, I am still extremely stiff in my wrist with some edema, and have limited mobility (maybe 10-15* flexion and extension, and I'm still not quite able to pronate and supinate my wrist but that is improving every day). I start PT on Thursday and plan to approach it as aggressively as I safely can.

The question is, for anyone who has had a break like this with an ORIF or similar surgery, what was your recovery time like to where you could get back on track, and was it tenuous or did you feel truly healed by that time?

I have a busy 2024 scheduled and I don't have any interest in a prolonged recovery, any anecdotes or advice would be appreciated as well.

 

Wrist injuries don't care about your schedule or interests. Heal up, man.

 

I'm 5 weeks post-op on a shoulder reconstruction, and got a little dose of reality this week. I'm aggressively chasing PT 3-4 days a week and ahead of schedule for the recovery related to the actual surgery, but the doc basically told me not to be an idiot and that no matter how hard I work, some of what they did just needs time to heal and can't be acceletrated. Just make sure you know the difference.

 

Man, that really stinks. Sorry to see.
Last November I had an off that broke 3 metacarpal bones in my right hand that still cause me pain and loss of motion. I imagine your wrist will be similar. You didn't mention your age, but you look close to mine and things are taking longer to heal these days.

Make sure you do all your PT and even the exercises you're supposed to be doing on your own. I hope you get back to your previous level soon.

 

Wish you the best. Mine wasn't as severe as what yours sounds like, but I did break both my Radius and Ulna in a crash. Surgery to put in some pins (which I later had removed). Had a soft cast and was supposed to keep it on for 8 weeks or something like that. Ended up doing a track day about 7 weeks later which was uncomfortable but worked.

Definitely was a gradual process to get range of motion back. Kept stretching and working it to avoid scar tissue and such. Had most of my usage back a couple months later but would still hurt doing specific things like opening a doorknob all the way. After a year or so I'd say I was about 98%. FWIW I was in my mid-20s.

 

You should be getting some follow up xrays to check on bone density improvements. So you don't need to worry about how it's healing - the xrays will show you.

I'd start working on mobility and range of motion immediately. You aren't going to back out a screw by doing unweighted movements of your wrist and forearm. Your PT appointment will probably agree. You may even get some putty to massage or a resistance band exercise or two. Then when bone density is good, you can start weighted exercises.

I broke my radius about 1" further down the bone in 2011. It could not be re-set, so it was plated. I had 1 follow-up xray that showed great bone density improvements. I had 1 PT appointment that told me to keep it moving. So I just went about my normal life as best as I could. The road buzz from riding a road bike was unbearable for almost 2 months. I probably got it to 90% range of motion and strength just by living normally. Then about 6 months after I broke it, I got into rock climbing and finished off the recovery.

Impact loads through that bone still hurt more than the other side. My bone has grown over the plate and screws. So that part is never changing. But it doesn't affect my life at all. I shouldn't be hitting those potholes on the bicycle anyway.

 

Depends on age! I had broken bones in my teens that were ready to race in 4-5 weeks. Same break (other side) in 40s took 4+ months.

 

I did the same thing to my ankle (ankle end of fibula) in the army several decades ago. same type of surgery and plate + screws. It took about 6 months to be mostly normal...healing in my late teens....but its never been 100%. I can run, jump, etc, but that ankle is weaker and more prone to rolling/spraining and occasionally just hurts for no reason. Like I am walking in a store and one step its fine, the next Im limping.

From what i hear wrists are worse. Take your time and dont rush it or it may be bad for the rest of your life.

 

Just turned 30, which doesn't feel old but it doesn't feel young any more.

 

I had a crash in December that did a number on my shoulder. It's the same shoulder that I had a clavicle plate put in back in 2015 from another crash. MRI showed two partially torn tendons (biceps and rotator cuff) and some arthritis and bone spurs from the old plate job for good measure.

PT has been painful, but I feel I'm making progress. I ice afterwards and that seems to help as I was basically walking around in pain all day, even waking up at night in pain. And that was with no running, no cycling, and no motorcycles as per doctors orders. It's been 6 weeks or so and I'm starting to see a light at the end of the tunnel. Seems to get better every day. Surgery would have meant giving up on the race season and I'm not ready for that just yet.

I am a fit 50 year old and it just seems everything from losing the extra holiday pounds to healing a soft tissue injury takes more time. Patience is not a virtue of mine.

I did BPC 157 peptides for 30 days. Don't know if it helped or not, as I have nothing to compare it to, but it can't hurt except in the wallet. Stem cells are around $4,000, BPC is around $300 for a month's supply. DON'T get it from Amazon.

I almost came here asking advice, but I have one of the best sports med Ortho docs in the southeast, and a great PT, so really this would just be looking for the answers I want, not the ones I've been given over and over.

Mentally it's tough- you have plans, you spend alot of time staying fit, putting every piece of the puzzle together and then something out of your control happens and you just have to roll with it. My advice is to find what you CAN do and attack that as well, like going to the gym and doing a shitload of legs and core.

The bottom line is that we're not in control, you just have to play the hand you're dealt. And be grateful every day you get to practice your hobbies / sports. You never know when you'll have that taken away from you.

 

I have a similar injury I did in 2001 at 34, 2 plates, 6 screws but, I shattered both the wrist bones. I was told no more push ups, or bench press (was a gym rat), due to the significance of the breaks, and limited range of motion expected. 6 weeks after the initial injury, I ruptured the same hand (right, and my dominant hand) thumb tendon. It was said, from the initial injury, blood flow issue. 4 months after the surgeries, I set my personal best bench pressing.

Now, I wanted back BAD. I had the best fracture guy in our area, and best sports med PT at my disposal. The biggest hurdle will be range of motion, and you may never get it all back. What I can tell you is, no matter what the surgeon says, get the hardware out, when you can. Yes, it is a set back, and you have to do it all over again but, hear me out... 17 years after my injury and surgeries, I had a screw break, or come loose, and cut my index finger tendon.

They went in and tried to remove the hardware but, by then the plates were welded in and part of my bone structure now, and screws were almost impossible to get to. They tried to remove all of the screws but, only 2 came out. The surgeon wrapped my tendons with a protective barrier against the screws, for my future.

That second surgery was worse than the first, the rehab was tougher, and longer, not just because of my age. The damage and surgeries, have now given me limited movement, and bent fingers, with lower grip strength. I still ride, I have raced (up until 2021), so you may be able to to it as well. Get the hardware out, so you dont have issues down the road. Most docs will tell you, if it isnt bothering you, leave it in. Hindsight is 20-20, I would go back and have it all taken out within a year.

Good luck!

Ski

 

Similar injury in 2021. Shattered wrist, fractured thumb, and skier's thumb (thumb tendon damage). Every person is different in their recovery timetable. I was 47 and wasn't stoked about the time it took to heal.

It was several months before I had the strength to operate the front brake on the street where I felt it was comfortable and not a risk. That said, I have nearly all of my range of motion.

Curious about getting the hardware out. I guess there is a risk either way.

 

Truly one of my favorite cases. Locking plates have massively improved treatment for this injury over the last 15 years. Gone are the external fixators and resultant stiffness that came with them. Ask your surgeon about when you can ride. He did a nice job.

 

Growth hormone, BPC-157 and TB-500 peptides.
Should accelerate your healing process significantly.

 

Do what your body needs now. If you are not a professional athlete chasing big money, think about it long term. I'm not saying turn into a sloth, just give your body what it needs. I have two breaks that were never set and a serious shoulder injury that has come back to haunt me.

 

Bit more damage but no problem mtn biking nor moto-ing just 6 months after. Still have nerve damage (damn scar tissue) and loss of range of motion. Main issue is yoga now. Still can't apply pressure when hand is open. Closed fist... no problem.

 

I appreciate all of your insights, it was incredibly helpful to see the range of injuries/recovery times specific to our sport.

The majority of information out there is geared towards the general population, but there aren't many activities that challenge hands/wrists like road racing does from a strength/dexterity perspective.

"[A] bit more damage"
Honestly the recovery time you listed is incredible all things considered.
My concern with Yoga is shared, I do quite a bit of normal yoga as well as Acro Yoga and stabilizing my partner is a major concern, it's one thing if I hurt myself, it's another if my flyer is looking for support and my wrist can't take it for some reason and they get hurt as a result.

Is your issue with yoga around full extension poses like downward dog or any plank type pose?

 

Take the time to fully heal, don’t rush it.

 

Rush the recovery. Push it as hard as you can stand. Bones heal faster when they have blood flow. Bones heal faster when they have some stimulation. Any extra time spent immobile is not maximizing either of those two things. Any extra time spent immobile is letting the area scar over, requiring more PT to fix. Any extra time spent immobile is letting the required muscles, tendons, and ligaments atrophy - again requiring far more PT to fix.

Even for soft tissue damage (if you have any), don't get stuck in the mindset that pain == not done healing. That is often not the case. Pain can also mean you are done healing and you need to get rid of scar tissue. And the longer you wait to get rid of scar tissue, the harder it becomes.

You probably need to advocate for yourself with healthcare professionals if you want anything better than "general population" care and outcomes. I couldn't count how many times I had to say "professional athlete" to convince someone to provide better care when I broke my collarbone. First they didn't want to plate it. Then they agreed. Then they didnt want to plate it again. Then my surgery was delayed twice. Every convo in between all those steps was "I'm a professional athlete and I need this shoulder back into its original spot. I need to be able to do pushups, pullups, and be 100% functional". Was I lying about being a pro athlete - somewhat. But I'm sure glad I did because the collarbone is perfect. I raced more, climbed more, and now cycle as much as I want.

I pushed the recovery on that collarbone. I was doing arm circles 2wks after the surgery. I saw the surgeon for a followup at 4wks and showed him. He was stoked. He complained about having to deal with lazy people that don't move an injury and ruin the recovery stats for his surgeries. He saw the bone density improvements he wanted. I asked him if I could race again at 6wks after. He said don't crash. I took home some trophies instead.

I wish I had taken that approach to recovery with my radius break a few years prior. I wasn't as physically active so I didn't see the need. But looking back, I bet my hand/grip/forearm strength would have rebounded a lot faster with a more active approach.