Intraarticular Fracture Discussion
Intraarticular fractures are those in which the break crosses into the
surface of a joint. They always result in some degree of cartilage damage.
In addition to the usual considerations in fracture management, the
relative position of the bone fragments and their relationship to ligament
attachments are critical. Ideally, the joint surfaces should be restored to
their original position and held there strongly enough that movement may be
started in the early postoperative period. This is not always technically
possible, and some cases cannot be helped by the most skillful surgery.
Some permanent loss of motion is to be expected and the joint may develop
degenerative arthritis as a result of the injury. In addition, possible
long term problems include presence of a palpable or visible bony
prominence, deformity, numbness, weakness, reflex sympathetic dystrophy and
others. Less likely problems include re-fracture, compression neuropathy
and tendon rupture. Surgical treatment of the fracture may be indicated
when the potential risks of surgery are felt to be justified by the
potential benefits of improving the alignment of the bones as they heal.
Hardware may be required to hold the fracture fragments in position. Even
with surgery, the fracture is still prone to the problems noted above in
addition to risks of surgery, such as infection, hardware related problems,
numbness, tender scars, residual deformity, as well as less common problems
such as anesthetic or drug related reactions, among others. Fracture
position may shift even after reduction, internal fixation and
immobilization. Future removal of hardware may be required. This type of
injury may result in degenerative arthritis.
Discussion Home Page