Fracture Fixation Rehabilitation
What is fracture fixation surgery?
When a broken bone requires surgery, the surgeon stabilises the fracture using hardware — plates, screws, nails, wires or external fixators — to hold the bone fragments in correct alignment while they heal. This is called fracture fixation, or open reduction and internal fixation (ORIF) when performed through a surgical incision. The goal is to restore the bone's normal anatomy and allow healing in the correct position, rather than relying on a cast alone.
Fracture fixation is performed across virtually every bone in the body. Common examples include plate and screw fixation of wrist fractures (distal radius ORIF), intramedullary nailing of tibia or femur fractures, ankle ORIF for bimalleolar or trimalleolar fractures, clavicle plating, humeral fracture fixation, and metatarsal fixation in the foot. The specific hardware used depends on the bone, the fracture pattern, and the demands placed on that bone during healing and beyond.
Why does physiotherapy matter after fracture fixation?
The fixation holds the bone — but it doesn't rebuild what's been lost. After a fracture and the surgery to fix it, the surrounding muscles are weakened from disuse, pain and inhibition. The joint above or below may be stiff from immobilisation or protective guarding. The neuromuscular system has lost some of its ability to coordinate movement accurately. And the bone itself, while healing, needs controlled loading to stimulate remodelling and full restoration of strength.
Without rehabilitation these deficits persist long after the fracture has healed radiologically. The result is a bone that is structurally intact but a limb that doesn't function properly — chronic stiffness, weakness, altered movement patterns and a significantly elevated risk of re-injury. Physiotherapy after fracture fixation is what converts a healed fracture into a functioning limb.
What does rehabilitation involve?
The specifics vary significantly depending on which bone was fractured, the type of fixation, and the weight-bearing restrictions prescribed by your surgeon. Your physiotherapist will work closely with your surgical team's protocol to ensure rehabilitation progresses in a way that protects the healing bone while maximising recovery of function.
In the early phase — typically the first two to six weeks — the focus is on managing swelling and pain, maintaining or restoring movement in the joints adjacent to the fracture, and activating the surrounding muscles within the constraints of your weight-bearing restrictions. For upper limb fractures this typically means hand, wrist and elbow exercises to prevent stiffness spreading beyond the injury site. For lower limb fractures it means maintaining hip and knee mobility and beginning gentle muscle activation while non-weight-bearing.
As healing progresses and your surgeon progressively allows more load through the bone — confirmed by X-ray evidence of callus formation — physiotherapy shifts toward active strengthening, progressive weight-bearing and functional movement retraining. This phase requires careful judgement about how much to push — the bone's healing timeline and the hardware's load tolerance are both relevant considerations.
In the later phase, full weight-bearing and functional activities are progressively reintroduced. Return to sport, manual work or other demanding activities is guided by objective strength testing and surgical clearance rather than symptoms alone. Most people are surprised by how long full recovery takes — healing a fracture radiologically takes three to six months for most bones, and restoring full strength and function typically takes longer again.
Common fractures we see at Articulate
While we manage fracture rehabilitation across all body regions, some of the most frequently seen presentations at our Tarragindi clinic include:
For patients whose fracture occurred in a workplace incident or motor vehicle accident, we provide WorkCover and CTP funded rehabilitation and liaise directly with insurers and treating teams. NDIS and DVA funding pathways are also available where applicable.
Clinical Pilates integrates well into the mid and later phases of fracture rehabilitation, providing a controlled environment for progressive loading and functional movement retraining. Real time ultrasound assists in retraining deep muscle activation where pain and swelling have disrupted normal neuromuscular patterns.
Our physiotherapists Bethany Kippen and Emma Cameron both have extensive post-surgical and fracture rehabilitation experience and are members of the Australian Physiotherapy Association.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
When a broken bone requires surgery, the surgeon stabilises the fracture using hardware — plates, screws, nails, wires or external fixators — to hold the bone fragments in correct alignment while they heal. This is called fracture fixation, or open reduction and internal fixation (ORIF) when performed through a surgical incision. The goal is to restore the bone's normal anatomy and allow healing in the correct position, rather than relying on a cast alone.
Fracture fixation is performed across virtually every bone in the body. Common examples include plate and screw fixation of wrist fractures (distal radius ORIF), intramedullary nailing of tibia or femur fractures, ankle ORIF for bimalleolar or trimalleolar fractures, clavicle plating, humeral fracture fixation, and metatarsal fixation in the foot. The specific hardware used depends on the bone, the fracture pattern, and the demands placed on that bone during healing and beyond.
Why does physiotherapy matter after fracture fixation?
The fixation holds the bone — but it doesn't rebuild what's been lost. After a fracture and the surgery to fix it, the surrounding muscles are weakened from disuse, pain and inhibition. The joint above or below may be stiff from immobilisation or protective guarding. The neuromuscular system has lost some of its ability to coordinate movement accurately. And the bone itself, while healing, needs controlled loading to stimulate remodelling and full restoration of strength.
Without rehabilitation these deficits persist long after the fracture has healed radiologically. The result is a bone that is structurally intact but a limb that doesn't function properly — chronic stiffness, weakness, altered movement patterns and a significantly elevated risk of re-injury. Physiotherapy after fracture fixation is what converts a healed fracture into a functioning limb.
What does rehabilitation involve?
The specifics vary significantly depending on which bone was fractured, the type of fixation, and the weight-bearing restrictions prescribed by your surgeon. Your physiotherapist will work closely with your surgical team's protocol to ensure rehabilitation progresses in a way that protects the healing bone while maximising recovery of function.
In the early phase — typically the first two to six weeks — the focus is on managing swelling and pain, maintaining or restoring movement in the joints adjacent to the fracture, and activating the surrounding muscles within the constraints of your weight-bearing restrictions. For upper limb fractures this typically means hand, wrist and elbow exercises to prevent stiffness spreading beyond the injury site. For lower limb fractures it means maintaining hip and knee mobility and beginning gentle muscle activation while non-weight-bearing.
As healing progresses and your surgeon progressively allows more load through the bone — confirmed by X-ray evidence of callus formation — physiotherapy shifts toward active strengthening, progressive weight-bearing and functional movement retraining. This phase requires careful judgement about how much to push — the bone's healing timeline and the hardware's load tolerance are both relevant considerations.
In the later phase, full weight-bearing and functional activities are progressively reintroduced. Return to sport, manual work or other demanding activities is guided by objective strength testing and surgical clearance rather than symptoms alone. Most people are surprised by how long full recovery takes — healing a fracture radiologically takes three to six months for most bones, and restoring full strength and function typically takes longer again.
Common fractures we see at Articulate
While we manage fracture rehabilitation across all body regions, some of the most frequently seen presentations at our Tarragindi clinic include:
- Wrist fractures — particularly distal radius fractures following a fall on an outstretched hand. These are among the most common fractures in adults of all ages and respond very well to physiotherapy-guided rehabilitation.
- Ankle fractures — bimalleolar and trimalleolar fractures requiring ORIF are frequently managed with a period of non-weight-bearing followed by a structured return to walking and activity.
- Tibial and femoral shaft fractures — often managed with intramedullary nailing, these require careful progressive weight-bearing and extensive lower limb rehabilitation.
- Clavicle and shoulder fractures — plated clavicle fractures and proximal humerus fixations require early shoulder mobility work followed by progressive strengthening.
- Foot and metatarsal fractures — particularly fifth metatarsal fractures and Lisfranc-associated bony injuries, where rehabilitation timelines are often longer than patients expect.
For patients whose fracture occurred in a workplace incident or motor vehicle accident, we provide WorkCover and CTP funded rehabilitation and liaise directly with insurers and treating teams. NDIS and DVA funding pathways are also available where applicable.
Clinical Pilates integrates well into the mid and later phases of fracture rehabilitation, providing a controlled environment for progressive loading and functional movement retraining. Real time ultrasound assists in retraining deep muscle activation where pain and swelling have disrupted normal neuromuscular patterns.
Our physiotherapists Bethany Kippen and Emma Cameron both have extensive post-surgical and fracture rehabilitation experience and are members of the Australian Physiotherapy Association.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
