Intraarticular Fractures

Overview

An intraarticular fracture is a fracture that crosses a joint surface. Such fractures also involve some cartilage damage. Fractures to joints are more complicated to treat and heal than simple fractures, as multiple bones are involved. Bone fragments inside the damaged joint may impede healing time and efficacy. Often, ligaments are torn or separated from the joint surfaces as well, also impeding the healing process.

Common areas of intraarticular fracture include the:

• Shoulder - may involve the humerus, scapula and acromion and coracoid processes, as well as the glenoid and articular cartilage
• Hip - - may involve some portion of the pelvis and the upper neck or head of the femur, as well as the hip's articular cartilage
• Elbow - may involve the lower end of the humerus, the upper end of the radius and the ulnar collateral ligament as well as cartilage between the bones
• Wrist - may involve the lower ends of the radius and the ulna, and the carpal bones, as well as cartilage found between each of the small bones of the carpals
• Knee - may involve the lower end of the femur, the patella or knee cap, and the upper ends of the tibia and/or fibula as well as articular cartilage and collateral ligaments
• Ankle - may involve the lower end of the tibia or fibula, the subtalar joint and the articular cartilage and the anterior tibiofibular and lateral collateral ligaments

Causes

• Blunt force trauma
• Automobile accidents

Symptoms

• Pain
• Limited use or range of motion
• Weakness
• Swelling
• Bruising

Diagnosis

• Visual observation
• X-rays
• CT scans
• MRI

Treatment

Immobilization is the first step toward stabilizing the joint. Following imaging, the doctor will attempt to realign bones in their proper place. If torn ligaments are observed, or bones have been shattered or pieces badly damaged, surgery will be required for proper reconstruction of the affected joint.

Surgery

In some cases, and depending on area and severity of fracture as well as tendons, ligaments, muscles and bones involved at the fracture site, surgery may be recommended in order to attempt the reconnection of bones, ligaments and tendons. Minimally invasive closed-reduction surgery will be attempted through arthroscopically assisted surgery, or the surgeon may opt for open-reduction fixation surgery.