Articular fractures

Douglas R Dirschl; J Lawrence Marsh; Joseph A Buckwalter; Richard Gelberman; Steven A Olson; Thomas D Brown; Adolpho Llinias

doi:10.5435/00124635-200411000-00006

$Articular fractures$

Journal article

Articular fractures

Douglas R Dirschl, J Lawrence Marsh, Joseph A Buckwalter, Richard Gelberman, Steven A Olson, Thomas D Brown and Adolpho Llinias

Journal of the American Academy of Orthopaedic Surgeons, Vol.12(6), pp.416-423

11/2004

DOI: 10.5435/00124635-200411000-00006

PMID: 15615507

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Abstract

Although injuries to articular cartilage may lead to radiographic osteoarthritis, pain, and decreased joint function, the actual effects of such injury and of its treatment on joint function are not completely understood. The mechanisms of repair after impact loading are different from those after frank disruption by fracture of the articular cartilage, but basic and clinical research both indicate that the resultant articular surface is prone to degeneration. The sensitivity of a joint to resultant incongruity varies considerably, depending on the thickness and modulus of the articular cartilage and the geometry of the joint. Also, factors other than articular congruity play a substantial role in determining outcomes after treatment. For these reasons, defining a single threshold for articular displacement that correlates with outcomes in all joints is not practical. Some articular fractures injure cartilage so severely that the joint will degenerate even with an accurate articular reduction. Also, radiographic evidence of osteoarthritis does not necessarily correlate with poor function. More reliable measurement techniques are needed to accurately assess how treatment affects arthritis, and factors other than articular congruity are needed to predict posttraumatic arthritis.

Rabbits

Fracture Fixation - methods

Prognosis

Risk Assessment

Humans

Clinical Trials as Topic

Fractures, Bone - diagnosis

Recovery of Function

Injury Severity Score

Diagnostic Imaging - methods

Joints - injuries

Animals

Fractures, Bone - surgery

Range of Motion, Articular - physiology

Fracture Healing - physiology

Joints - surgery

Disease Models, Animal

Fracture Fixation - instrumentation

Details

Title: Subtitle: Articular fractures
Creators: Douglas R Dirschl - Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7055, USA
J Lawrence Marsh
Joseph A Buckwalter
Richard Gelberman
Steven A Olson
Thomas D Brown
Adolpho Llinias
Resource Type: Journal article
Publication Details: Journal of the American Academy of Orthopaedic Surgeons, Vol.12(6), pp.416-423
DOI: 10.5435/00124635-200411000-00006
PMID: 15615507
NLM abbreviation: J Am Acad Orthop Surg
ISSN: 1067-151X
eISSN: 1940-5480
Publisher: United States
Grant note: P50 AR48939 / NIAMS NIH HHS
Language: English
Date published: 11/2004
Academic Unit: Stead Family Department of Pediatrics; Orthopedics and Rehabilitation; Injury Prevention Research Center
Record Identifier: 9984040358902771

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