Peri-Articular Fractures

A peri-articular fracture is a break that occurs close to, or extends into, a joint — commonly the knee, hip, shoulder, elbow, wrist or ankle. These are among the trickiest injuries in orthopaedics: if the joint surface heals unevenly by even a couple of millimetres, it can lead to stiffness, pain and early arthritis.

Treatment focuses on rebuilding the joint surface precisely and stabilising it strongly enough to allow early movement — because a joint that stays still too long becomes stiff forever.

• Pain and swelling centred around a joint after injury
• Inability to bend, straighten or bear weight through the joint
• Visible bruising or blood-filled swelling of the joint
• A grinding or unstable feeling when attempting to move
• Deformity around the knee, ankle, wrist or shoulder

Along with X-rays, a CT scan is almost always performed to see the joint surface in fine detail and plan the exact placement of plates and screws before entering the operating theatre.

Surgery typically involves anatomic reconstruction of the joint surface, fixed with specialised contoured plates and locking screws. Where the joint is too damaged, replacement may be the better option. Stable, well-fixed joints are moved early under physiotherapy guidance to prevent stiffness.

Movement of the joint often begins within days of surgery, while full weight-bearing is introduced gradually over 6–12 weeks. Dedicated physiotherapy is essential — the joint's future mobility is decided in the first three months.