Joint fractures are breaks that reach the cartilage surface of a joint or lie next to it, such as fractures of the shoulder, elbow, wrist, hip, knee and ankle. These fractures need careful assessment because the condition of the joint surface can affect how the joint moves afterward.
Note: If you suspect a fracture near a joint, keep the limb still, do not move it unnecessarily and do not try to straighten it yourself. Seek urgent care if there is an open wound, clear deformity or numbness.
Symptoms
- Severe pain in and around the joint
- Rapid swelling and bruising
- Being unable to move the joint or put weight on it
- A change in the shape of the joint
- A grating or cracking feeling inside the joint
- Numbness or coldness in the limb
Causes
- A fall onto an outstretched hand, the elbow or the shoulder
- Road traffic accidents and high-force injuries
- Violent sports injuries
- A severe twist of the ankle or knee
- Weak bone, which can make a joint more prone to fracture in a fall
- A joint dislocation that comes with a fracture
Diagnosis
The doctor examines the joint and checks feeling and circulation in the limb. X-rays are requested, a CT scan is often used to show the details of the fracture and the joint surface, and an MRI may be requested to assess ligaments and cartilage.
Joint fractures can come with ligament injuries, so a full assessment is carried out.
Treatment options
Non-surgical treatment
As general first aid: keep the joint and limb still in the position you found them, avoid moving it, apply a cold pack wrapped in a cloth and seek medical care. Do not try to put the joint or bone back yourself.
When the fracture is stable and the joint surface is in an acceptable position, non-surgical treatment may be enough.
- A splint, cast or brace to hold the joint
- Rest and avoiding weight on the joint
- Follow-up X-rays to check the fracture stays stable
- Physiotherapy after the fracture has healed
Surgical treatment
Surgery is often considered when the joint surface is displaced or the fracture is unstable, because restoring and fixing the joint surface may help preserve movement. Fixation methods such as plates and screws are used, and arthroscopy may help in some cases. In some complex fractures, joint replacement may be discussed when needed. The surgeon decides what suits you after assessment.
Recovery and rehabilitation
Recovery time varies from person to person and is set by the surgeon after assessment. Rehabilitation is especially important after joint fractures, to limit stiffness and restore movement.
- Protecting the joint and keeping to the support
- Controlling pain and swelling
- Starting gentle movement when the surgeon allows
- Gradually restoring range of motion
- Strengthening the muscles around the joint and returning to activities step by step
When to see the doctor
Seek urgent medical care if:
- The joint looks clearly deformed
- There is an open wound near the joint
- There is numbness, paleness or coldness in the limb
- You cannot move the joint or stand on it
- The pain is severe after a fall or accident
- Pain or swelling gets worse during treatment