Periarticular Fracture
Periarticular Fracture: Causes, Treatment, and Recovery
A periarticular fracture is a fracture that occurs near a joint (but does not extend directly into the joint). These fractures often affect the knee, hip, shoulder, elbow, or ankle and can impact joint stability, function, and long-term mobility.
Causes of Periarticular Fractures
High-energy trauma – Car accidents, falls from height, sports injuries.
Low-energy trauma (in elderly) – Osteoporotic fractures due to simple falls.
Overuse injuries – Stress fractures near joints (common in athletes).
Types of Periarticular Fractures
- Supracondylar fractures (above the knee or elbow).
- Intra-articular fractures (fracture extends into the joint).
- Metaphyseal fractures (near the wider ends of long bones).
- Comminuted fractures (bone breaks into multiple pieces near the joint).
Symptoms
Severe pain & swelling near the affected joint.
Bruising & deformity around the fracture site.
Limited movement or inability to bear weight.
Joint instability if ligaments are also injured.
Diagnosis
X-ray – Identifies fracture type and alignment.
CT Scan – Detailed imaging for complex fractures.
MRI – Assesses ligament and cartilage damage if joint involvement is suspected.
Treatment Options
Non-Surgical Treatment (For Stable, Non-Displaced Fractures)
Immobilization – Cast, brace, or splint for 6-8 weeks.
Pain Management – NSAIDs or mild opioids.
Physical Therapy – To restore movement and strength.
Surgical Treatment (For Displaced or Unstable Fractures)
Indications for Surgery:
Fracture extends into the joint.
Bone misalignment or multiple fragments.
Joint instability.
Surgical Procedures
Open Reduction and Internal Fixation (ORIF) – Plates, screws, or rods stabilize the bone.
External Fixation – Temporary frame if swelling is severe.
Joint Replacement – In severe cases, especially in elderly patients.
Recovery & Rehabilitation
Hospital Stay: 3-7 days (depending on surgery).
Weight-Bearing: Partial weight-bearing for 6-12 weeks if surgery is performed.
Full Recovery: 3-6 months (or longer if complications).
Physical Therapy Focus:
- Early motion exercises to prevent stiffness.
- Strength training for surrounding muscles.
- Gradual return to normal activities.
Complications & Long-Term Effects
Joint Stiffness & Arthritis – Common in intra-articular fractures.
Malunion or Nonunion – If healing is poor.
DVT (Blood Clots) – Risk due to immobility.
Muscle Atrophy – Prevented with early rehab.
Prognosis
Good outcome with proper treatment and rehab.
Delayed or improper healing may lead to chronic pain and joint dysfunction.
