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Therapy after skeletal fixation in the hand and wrist.

Skeletal fixation can be very beneficial to the recovery of wrist and hand function after a displaced fracture because it allows mobilization of soft tissues before the completion of fracture healing. The benefits of skeletal fixation can be greatly diminished, however, if excessive force causes the fixation to fail before fracture healing has occurred, infection occurs around the implant, or the patient develops reflex sympathetic dystrophy. Those complications, as well as others, are often caused by inappropriate or inadequate hand therapy. This article discusses the techniques needed to avoid many such complications while providing the best possible functional result for every patient.