Periarticular Fractures – The Treatment
It won’t be wrong to say that fractures are known to be one of the most common traumatic injuries. During trauma, the fracture could either occur in one bone or involve multiple bones in different parts of the body. In many cases, the fracture is seen inside or surrounding a joint, such fractures are known as periarticular fractures.
Periarticular fractures can also damage cartilages on the fractured bone ends along with joint tissues. The most commonly affected joints in the case of periarticular fractures are knee, thigh, shin, elbow, ankle, and wrist. Whereas, Knee periarticular fractures are commonest of all. The treatment of the fracture may be done with or without the use of trauma implants.
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What Causes Periarticular Fractures?
Most fractures occur due to traumatic injuries and high-energy trauma is also one of the causes of periarticular fractures. High-energy traumas involve high-impact car collisions or crashes, contact sports injuries, falling from a great height, and other related unexpected events. Besides these, periarticular fractures can also result due to certain diseases that weaken your bones like osteoarthritis, osteoporosis, & tumor. Fractures due to bone-related diseases are more common in the elderly than in adults.
Symptoms Seen in the Case of Periarticular Fractures
Symptoms may vary according to the location and severity of the fracture. Below-mentioned are some of the common symptoms of periarticular fractures that may be noticed:
- Pain in the affected area
- Mobility problems
- Joint stiffness
- Instability of the joint
- Inflammation of surrounding connective tissues
How Periarticular Fractures are Diagnosed?
Diagnosis of the condition starts with a physical examination by the doctor where he/she will assess the symptoms along with the cause of the fracture. Plus, the physical examination will also tell whether the patient has suffered any other injuries and this knowledge will be critical in defining the right treatment procedure.
Once the physical examination is done, the doctor will indicate an X-ray to see where exactly the fracture has occurred. Apart from this, other imaging tests like CT scan or MRI scan may also be performed in certain cases to know how severe the fracture is. This will help the doctor decide which type of treatment will be the best.
The location of the fracture and its severity will decide whether surgery will be required or fracture can be fixed non-surgically. There are some options in both the types of treatment procedures:
Non-surgical treatment is the best when the fractured bone fragments stay in their place after the injury. For mild fractures, the orthopedist may apply a splint or a cast to prevent mobility of the fractured bone fragments. In non-severe cases, immobilizing the bone fragments with a cast or splint application is known to help heal the fracture. Along with this, over-the-counter pain medications are also indicated to manage pain.
If the involvement of the knee or hip joint is there, then the use of walking aids is suggested to prevent the worsening of the fracture. Besides all this, closed reduction and physical therapy are required in certain cases.
Surgery is the only option in severe and emergency cases of periarticular fractures. Open reduction and internal fixation (ORIF) surgery using orthopedic implants like IM Nail or Hand Plating System is preferred to realign fractured bones and hold them in position until they heal. In certain cases, bone grafting, joint replacement, or osteotomy may also be done depending upon the condition of the fracture.