Total wrist arthroplasty (Voltz) therapy

Postoperative dressing.

3 weeks:

The postoperative dressing is removed.

Edema control is applied as needed.

A Wrist Immobilization splint is fitted in 15 degrees of dorsiflexion to be worn between exercise sessions and at night.

Active and gentle Passive Range of Motion exercises for the wrist and digits are initiated 6-8 times a day for 15 minute sessions.

Dynamic splinting may be initiated as needed to increase Passive Range of Motion of the digits.

Electrical Stimulation may be used as needed to facilitate wrist Range of Motion. (The EDC occasionally becomes adherent over the incisional site and electrical stimulation may be beneficial here as well). Extrinsic extensor tightness may be a problem and must be resolved in the early rehabilitation phase.

6 weeks:

Full Passive Range of Motion is initiated with attempts to minimize radial and ulnar deviation of the wrist.

Dynamic splinting may be used as needed to increase Passive Range of Motion of the wrist, and the Wrist Immobilization splint may be decreased as tolerated.

8 weeks:

Gentle progressive strengthening of the wrist and hand may be initiated.

12 weeks:

Normal activities may be gradually be resumed.

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