Painful wrist swelling and limited palmar flexion activities mostly occur in patients with distal radius fractures, with painful wrist swelling and especially limited palmar flexion activities. A distal radius fracture is a fracture within 2 to 3 cm above the articular surface of the distal radius. Fractures of the distal radius are common and account for about 1/6 of all fractures in the body. 1. Fractures without displacement Immobilize the wrist joint in a functional position for 3 to 4 weeks with a small splint or cast. 2. Displaced extension fractures or flexion fractures can be successfully repositioned by manipulation. For extension fractures, non-comminuted fractures that do not involve the joint surface are often repositioned by shaking; for elderly patients, comminuted fractures that involve the joint surface are often repositioned by lifting and pressing. After repositioning, the wrist is kept in palmar flexion and ulnar deviation and fixed in a cast or external fixator for 4 weeks. In flexion fractures, the direction of repositioning is reversed after longitudinal traction, and after repositioning, the wrist joint is fixed in dorsiflexion and rotation anterior position for 4 weeks. After fixation, X-ray should be taken to check the alignment. After the swelling subsides in 1 week or so, X-ray should be taken to review the fracture, and if re-displacement occurs, it should be handled promptly. 3. Comminuted fractures that are difficult to reposition or not easily maintained after repositioning (such as Baltong fracture) often require surgical repositioning and internal fixation with a Kirschner pin, screw or T-shaped plate. 4.Management of comorbidities Those whose fracture deformity connection leads to functional impairment should be operated to correct the deformity and internal fixation. If the lower ulnar radial joint dislocation affects forearm rotation, the small head of ulna can be removed. In case of combined median nerve injury, if the nerve does not recover after 3 months of observation, the nerve should be explored and released, and the protruding bone end should be repaired. In cases of delayed thumb tendon rupture, the bone should be removed and the tendon should be repaired. Those with osteoporosis should be treated accordingly to prevent the occurrence of other serious fracture (such as femoral neck fracture) comorbidities. 5. Functional exercise During the period of fracture fixation, attention should be paid to the movement of the shoulder, elbow and fingers. Especially for the elderly, it is necessary to prevent stiffness of the shoulder joint. (a) The basic principle of functional exercise is to maintain the alignment of the fracture to promote fracture healing and to prevent deformity by restoring the joint function. Establish the confidence to overcome the disability, adjust the best state of mind, and master the correct exercise method and meaning. Functional exercise starts after the fracture is repaired and continues throughout the treatment course. The number and amplitude of activities should be based on the clinical process and the degree of stability of the fracture, the number of activities should be increased gradually, the amplitude of movements should be from small to large, and the weight should be held from light to heavy (special note: weight holding should be started only after 4 weeks), the movements should be coordinated, symmetrical and balanced, and the activities that cause rotation, separation, angularity and harmful shearing of the fracture end should be avoided. (B) Functional exercise of the distal radius: At the early stage of fixation, it is necessary to know the necessity of functional exercise and the possible complications of the fracture as well as the prevention methods of the complications, which should be paid great attention. 1, early fracture (the first day to 2 weeks after the injury): after the fracture is reset, you can do two movements: make a fist, straighten and open the five fingers, in order to exercise the interphalangeal and metacarpophalangeal joint activities and exercise the forearm muscle active contraction. Functional exercises during this period are very helpful to reduce swelling! In elderly patients, special emphasis should be placed on the importance of shoulder joint activities. 3 days after the injury, the shoulder joint should be exercised for forward flexion, backward extension, internal contraction, external rotation and circular rotation to prevent the occurrence of shoulder-hand syndrome. Pay attention to the changes in blood flow and superficial sensation at the fingertips. Review the X-ray film. 2.Mid-term fracture (i.e. 3~4 weeks after injury): The bone scab is gradually generated and matured, the local swelling disappears, and the fracture is close to clinical healing on the basis of the early functional exercise, start the practice of wrist dorsiflexion and radial deviation activities, forearm rotation activities, gradually increase the degree of activity to avoid the fracture from re-dislocation. Release the splint at 4 weeks (3 weeks for children). 3.Late stage of fracture (after 4 weeks of fracture): In the late stage, the fracture has reached the standard of clinical healing and the external fixation has been released, the patient should be guided for different conditions, especially the mobility of the wrist and elbow joints, and for those with different degrees of joint dysfunction, adequate exercises should be carried out. The functional exercise during this period is very helpful to prevent tendon adhesions!