Jak leczę… złamania wewnątrzstawowe. Cz. I

How I treat…intra-articular fractures. Part I

Intra-articular fractures (IF) are defined as fractures involving joint surfaces of a specific joint. This definition in strict sense is often extended so that the intra-articular fracture is considered as the one involving any area in the joint, this is, occurring within the limits of the synovial membrane. Intra-articular fractures involve some specific problems to the orthopedic surgeon, and all aspects should be well known in order to minimize the probability of surgical failure. These problems are the following:

Localization and approach

The most intra-articular fractures have difficult approach, since the fractured fragment uses to be in areas of difficult visibility. Therefore, in many IF a series of approaches are needed by osteotomies that extent the surgical length, as it occurs in „Y” or „T” type humerus condyle fractures (approach by olecranon osteotomy) or acetabule fractures (trochanter osteotomy) (fig. 1, p. 90).

Fragments size

The size of fragments in many IF is quite small, which complicates the fracture reduction efforts. Especially significant cases in this regard are avulsion fractures and comminuted and avulsion fractures.

Avulsion fractures occur when a bone fracture detaches due to forces exerted by tendons and ligaments. Especially dangerous due to their ability to cause IF are ligaments avulsions, such [...]

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