Complications of fractures include early and late complications, early complications was explained in the previous article, now in this article late complications like joint stiffness, joint instability and osteoarthritis will be explained
Joint stiffness
- in this fracture complication, The joint become difficult to move and it mostly occur after fractures
- Common locations: knee joint, elbow, shoulder, small joint of the hands
- Causes include joint capsule fibrosis, adhesions and edema that occur due to prolonged immobilization of the joint
- Treated by exercising the joints early after the fracture occurred, if already stiffed then physiotherapy is needed
Joint instability
- Sensation of the joint may give away
- Causes include ligamentous laxity, muscle weakness and bone loss
- Joint instability may lead to recurrent dislocations, esp. in the shoulder and patella
Osteoarthritis
- OA is degeneration of the joint cartilages
- Occurs when the fracture is inside the joint capsule damaging the articular cartilage
- It is either post traumatic OA occurs in periods of months after injury due to direct damage to the articular cartilage or secondary arthritis that occur years later due to irregularity of the joint surface because of not so perfect reduction
Avascular necrosis
- Some bones and parts of bones have high risk of developing ischemia and necrosis after injury due to poor blood supply
- Common bone:
- The femoral head
- The proximal part of the scaphoid bone
- The lunate bone
- The body of the talus bone
- Ischemia occurs initially following the injury but clinical features and radiological features of the necrosis seen after weeks or months
- Patient present with pain at the injured bone
- X ray shows osteopenia, patchy sclerosis, rim calcification
Bed sores
- Ulcers form due to prolonged pressure on the skin mostly in elderly and paralyzed patients or from wearing a cast for long time
- The commonly form over the sacrum, heals
- Treatment is difficult, excision and grafting is an option and negative pressure dressing is advised
Course Menu
This article is apart from Orthopedic Trauma Basic Principles Course, This course covers these topics: