Intra Articular Fracture

An intra-articular fracture is a type of bone fracture where the break extends into the surface of a joint. This means that the fracture line crosses the articular cartilage and affects the joint surface. These fractures can be particularly challenging to treat because they involve the joint surface, which must be precisely aligned to ensure proper joint function and to prevent long-term complications like arthritis.

Causes

Intra-articular fractures can result from:

High-Energy Trauma: Such as car accidents or falls from a height.
Sports Injuries: Particularly in high-impact or contact sports.
Low-Energy Trauma: In older adults with osteoporosis, even minor falls can cause these fractures.

Common Sites

Intra-articular fractures can occur in any joint, but they are most commonly found in:

Knee (Tibial Plateau Fractures): Fractures involving the top part of the shinbone that forms part of the knee joint.
Ankle: Fractures involving the bones that make up the ankle joint (e.g., distal tibia, talus).
Wrist (Distal Radius Fractures): Fractures involving the end of the radius bone near the wrist joint.
Elbow: Fractures involving the distal humerus or proximal ulna/radius.
Shoulder (Proximal Humerus Fractures): Fractures involving the upper part of the humerus bone.

Symptoms

Pain: Severe pain at the site of the fracture, especially with movement.
Swelling: Swelling around the affected joint.
Bruising: Discoloration due to bleeding under the skin.
Deformity: Visible deformity if the fracture is displaced.
Limited Mobility: Difficulty moving the affected joint.
Crepitus: A crackling sound or sensation with joint movement.

Treatment

The treatment of intra-articular fractures aims to restore the normal anatomy of the joint to ensure proper function and minimize the risk of arthritis. Treatment options include:

Non-Surgical Treatment:

Immobilization: Cast or splint to immobilize the joint and allow healing.
Rest, Ice, Compression, Elevation (RICE): To manage pain and swelling.
Pain Management: Medications to relieve pain.
Physical Therapy: To restore range of motion and strength once the fracture has healed.

Surgical Treatment:

Open Reduction and Internal Fixation (ORIF): Surgery to realign the fracture fragments and fix them in place using plates, screws, or pins.
External Fixation: A frame outside the body is used to stabilize the fracture if internal fixation is not feasible.
Arthroscopic Surgery: Minimally invasive surgery to repair the joint and remove any loose fragments.

Rehabilitation

Physical Therapy: Critical for restoring joint function, range of motion, and strength.
Gradual Weight Bearing: Depending on the fracture location and healing progress, weight-bearing activities are gradually reintroduced.
Long-Term Monitoring: Regular follow-up visits to monitor healing and address any complications.

If you would like to have additional information contact Dr. Vipul Shet, serving communities and people from all walks of live.