OBJECTIVE: To determine the effect of 2 different postoperative therapy approaches after operative stabilization of the wrist fractures: treatment by a physical therapist with 12 sessions and an unassisted home exercise program. DESIGN: Randomized controlled cohort study. SETTING: Hospital-based care, primary center of orthopedic surgery. PARTICIPANTS: Volunteers (N = 48) with fractures of the distal radius after internal fixation with locking plates. There were 46 patients available for follow-up after exclusion of 2 participants due to physiotherapy sessions in excess of the study protocol. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Evaluation of grip strength using a Jamar dynamometer, range of motion (ROM), and Patient Related Wrist Evaluation (PRWE). RESULTS: After a 6-week period of postoperative treatment, the patients (n = 23) performing an independent home exercise program using a training diary showed a significantly greater improvement of the functionality of the wrist. Grip strength reached 54% (p = 0.003), and ROM in extension and flexion 79% (p < 0.001) of the uninjured side. Ulnar and radial abduction was also higher in this group. In contrast, patients who were treated by a physical therapist achieved grip strength equal to 32%, and ROM in extension and flexion of 52% of the uninjured side. Patients who were performing the home training after operation recorded an improved wrist function with a nearly 50% lower value (p < 0.001) in the PRWE score. CONCLUSIONS: In the postoperative rehabilitation of wrist fractures, instructions in a home exercise program are an effective alternative to prescribed physical therapy treatment.

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