These are '''intra-articular fractures''', and therefore repair should follow certain principles:
These are '''intra-articular fractures''', and therefore repair should follow certain principles:
:'''Anatomic reduction and alignement''': avoid steps in the joint surface and exposure of the fracture to synovial fluid
:'''Anatomic reduction and alignement''': avoid steps in the joint surface and exposure of the fracture to synovial fluid
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:'''Rigid stabilisation with compression''': to achieve direct bone healing. A '''lag screw''' is the idea method of fixation, as it will compress and provide rigid stability. A second point of fixation such as a K-wire or a second screw will add rotational stability. Rigid fixation also allow '''early limb use''' and helps maintain joint function and range of motion
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:'''Rigid stabilisation with compression''': to achieve direct bone healing. A '''lag screw''' is the ideal method of fixation, as it will compress and provide rigid stability. A second point of fixation such as a K-wire or a second screw will add rotational stability. Rigid fixation also allow '''early limb use''' and helps maintain joint function and range of motion
:'''Post-operative management''': cold compresses, good analgesia, exercise restriction and physiotherapy
:'''Post-operative management''': cold compresses, good analgesia, exercise restriction and physiotherapy
:'''Avoid prolonged immobilisation''' of the joint.
:'''Avoid prolonged immobilisation''' of the joint.
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Post-traumatic '''osteoarthritis''' is inevitable even with a perfect repair. Areas of damage tend to be replaced by biomechanically inferior fibrocartilage.
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Post-traumatic '''[[osteoarthritis]]''' is inevitable even with a perfect repair. Areas of damage tend to be replaced by biomechanically inferior fibrocartilage.