X-ray of a wrist with

osteoarthritis before (left)

and after (right) wrist
replacement surgery
using a two-part metal
and polyethelene implant.
X-ray of a wrist with
severe rheumatoid
arthritis throughout the
wrist before (left) and
after (right) replacement
of the wrist joint with a
silicone rubber implant
Total wrist arthroplasty (Voltz) therapy


0 - 3 weeks: Postoperative dressing.
Active / active assisted: flexion / extension wrist; radial / ulnar
deviation wrist
Splint to be worn between exercises and at night
Active / passive movement of digits as appropriate
Functional use of hand in splint and avoiding transmitting power
across wrist joint



3-6 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.
Extrinsic extensor tightness may be a problem and must be resolved
in the early rehabilitation phase.

6-8 weeks:
Full Passive Range of Motion is initiated with attempts to minimize
radial and ulnar deviation restriction 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.
8-12 weeks:
Gentle progressive strengthening of the wrist and hand may be
initiated.
12 weeks:
Normal activities may be gradually be resumed.