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Fixation of the hand is a surgical operation performed on an unstable fracture of the hand. It is performed to realign the bones of your hand and promote effective healing. This injury can be caused in a number of ways including crush injury, sports injury and falls. These fractures can occur at your metacarpo-phalangeal joints (knuckle), your proximal and distal interphalangeal joints (finger knuckle) and your carpometacarpal joint (thumb joint).

Functional hand exercises supervised by a PhysiotherapistAbove: Functional hand exercises supervised by a Physiotherapist

There are various methods performed depending on the location and severity of fracture. These methods include:
  • External Fixation – here pins are placed through the skin and fixated with rods either side of the skin.
  • Internal Fixation – here pins, screws and/or wires are attached internally on to the bone.
  • Closed Reduction – the bones are re-aligned without surgery and placed in a cast or split to promote healing.
  • Open Reduction – the bones are exposed and realigned through surgery.
When your fracture is displaced (ends of the bone are separated), unstable (bones lack stability) or open (pierces the skin) then a surgical approach will be necessary with an ORIF routinely performed. Following surgery, will assess the success of your operation and construct an effective rehabilitation plan in order to help restore hand function.

Soft tissue massage of the palma fascia by specialist therapistAbove: Soft tissue massage of the palma fascia by specialist therapist

Symptoms after Hand Fixation Surgery

Following hand fixation surgery it is normal for you to experience certain symptoms which are characteristic of this surgery. These include:
  • Swelling
  • Pain
  • Stiffness
  • Reduced Range of movement and strength
In order to minimise these symptoms and maximise recovery, it is essential you have a personal physiotherapy programme developed by

Physiotherapy after Hand Fixation Surgery

Following hand fixation surgery, can immediately compile a thorough assessment of your hand and develop a personal rehabilitation programme specific to your needs. Rehabilitation will focus not only on restoration of movement and strength but on activities needed to return to active work, hobbies and sports. Treatment will begin following your surgery with full recovery seen in approximately 16 weeks.

Week 1-3

Initial treatment will centre on minimising post-operative complication, reducing pain and swelling, maintaining fracture stability and encouragement of early movement. Through focussing on these areas will help promote healing capability and provide a foundation for the restoration of a fully functioning hand. Treatment will consist of:
  • Cryotherapy
  • Pain management
  • Electrotherapy modalities
  • Controlled passive movements
  • Wound monitoring
  • Splinting
  • Active movements of entire upper limb to prevent stiffness, loss of movement and strength
  • Advice

Weeks 4-8 will focus on a progression of exercises to help improve movement and strength and restore functional movement of your hand. Your pins and wires will have been removed allowing to intensify sessions to ensure restoration of function. Treatment will include:
  • Continuation of passive movements to full range of motion
  • Progression to active movements of hand, wrist and fingers to reach full range
  • Begin strengthening exercises
  • Soft tissue mobilisation
  • Splint adjustment
  • Wound and scar management

Weeks 9-16

During the latter stages of your rehabilitation, will intensify your treatment with the ultimate goal of regaining full function and strength of your injured hand. Splint use will have stopped with attention paid to restoration of previous functional activities and a return to social and sporting activities. Treatment will include:
  • Full active and passive range of motion
  • Progressive strengthening programme
  • Isolated strengthening of fracture
  • Functional activity exercises
  • Soft tissue mobilisation
  • Hand dexterity
  • Advice and long term management
Following the completion of a comprehensive rehabilitation programme with you will have achieved significant improvements in movement, function and strength. will then provide you with the necessary knowledge and exercises needed to maximise recovery and prevent any future complications.


Fixation of the hand is a common surgical procedure performed on fractures of the fingers and thumb. Hand fractures are common injuries that may significantly affect hand function if not managed properly. With severe cases it will be necessary to undergo a surgical operation to re-align the broken bones. Following this it is essential to undergo a comprehensive rehabilitation programme. will develop a specific treatment programme designed around your needs to maximise rehab potential to help restore full functional use of your hand. Call now on 0330 088 7800 for more information or to book an appointment please contact us.

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