Post-Operative Rehabilitation for Distal Radius Fracture Fixed with JESS

Immediate Post-Operative Phase (Day 0-3 weeks)

The American Academy of Orthopaedic Surgeons recommends beginning active finger motion exercises immediately following surgery while the JESS fixator is in place, and initiating wrist mobilization at 1-3 weeks post-operatively based on fracture stability and fixation adequacy 1, 2
Active finger motion exercises should be started on post-operative day 1 to prevent hand stiffness, which is the most functionally disabling complication following distal radius fractures 1, 2, 3
Patients should be instructed to move all fingers regularly through complete range of motion multiple times daily 1, 4
Finger motion does not adversely affect adequately stabilized fractures regarding reduction or healing 2, 3, 4
This intervention is extremely cost-effective and prevents complications that require multiple therapy visits or surgical intervention if left untreated 2

A home exercise program is equally effective as supervised physiotherapy for uncomplicated cases, according to the American Academy of Orthopaedic Surgeons 1
Supervised therapy should be reserved for patients developing complications such as stiffness or complex regional pain syndrome 1

For uncomplicated JESS fixation, active finger ROM only should be performed from days 0-21, with JESS in place 2
For uncomplicated JESS fixation, active wrist ROM exercises (flexion/extension/rotation) should be added from weeks 3-6, with continued finger exercises 2

The American Academy of Orthopaedic Surgeons recommends never restricting finger motion during the immobilization phase, as failure to encourage early finger exercises leads to severe stiffness requiring extensive therapy or surgery 1, 2, 4
The American Academy of Orthopaedic Surgeons advises against routinely prescribing supervised physiotherapy for all patients, as home exercise programs achieve equivalent outcomes in uncomplicated cases 1
Any patient with unremitting pain during follow-up should be reevaluated, as this may indicate complications such as DRUJ instability, malunion, or complex regional pain syndrome 1, 4

Radiographs should be obtained at 10-14 days post-operatively to ensure fracture position is maintained 3
Patients should be monitored for development of finger stiffness, persistent pain, or loss of reduction 1, 4