Osteochondral fractures occur when the articular cartilage at the end of a joint tears, commonly in the knee and ankle. Treatment options range from rest and casting to surgery, depending on the severity. Fragments of bone and cartilage can cause further damage and pain. Early identification is important to prevent osteoarthritis.
An osteochondral fracture is a type of fracture in which the articular cartilage at the end of a joint tears. These fractures are most commonly seen in the knee and ankle joints, as these joints require a lot of strain and bear a lot of weight, which can make them vulnerable to damage. Depending on the severity of the fracture, there are a number of treatment options ranging from fairly conservative treatments to surgery. It is important to treat this type of fracture because such fractures can lead to the development of osteoarthritis later in life.
When an osteochondral fracture occurs, it is common for there to be fragments of bone and cartilage within the joint. Sometimes they remain attached to the joint, in which case they are known as stable, while in other cases they are unstable, floating within the joint. These fragments are a cause for concern because they can shatter the joint, causing further damage as well as making the joint quite painful.
An X-ray can be used to identify an osteochondral fracture, and sometimes other medical imaging studies can be used to get a more complete picture of what’s happening inside the joint. These studies are also used to recommend treatment. In a mild osteochondral fracture, treatment can be as simple as rest and casting to allow the joint to heal on its own. Younger patients often heal very well with this type of treatment because their growing bodies allow the joint to heal quickly and reach out to the rest of the body.
If fragments are present, it may be necessary to enter the joint to remove the fragments and stabilize the joint. Large missing pieces can be replaced with a graft so that the joint remains relatively stable after the fracture heals. Surgery is often done arthroscopically, inserting cameras and surgical tools through small incisions around the joint to gain access to the affected area. After surgery, casting can be used to keep the joint still in the early stages of healing.
The healing time from an osteochondral fracture varies depending on the severity of the fracture. One of the problems with these fractures is that they often go unrecognized in the early stages. The patient may think the joint is just stiff and sore, without realizing that ongoing damage is occurring. By the time the fracture is identified, the situation may be much more serious and more extensive treatment may be required.
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