Intra-articular Fractures

Intra-articular fractures may result in stiffness, deformity, pain, and post-traumatic arthritis. In order to avoid deformity and stiffness it is necessary to secure an anatomical reduction and begin early motion. Sir John Charnley stated that “perfect anatomical restoration and perfect freedom of joint movement can be obtained simultaneously only by internal fixation” (Charnley 1961) . At the time that Charnley wrote The Closed Treatment of Common Fractures, sufficiently stable and suffiiciently strong internal fixation which would allow early motion was not available. Indeed, the results of internal fixation were so discouraging because of stiffness, deformity, delayed union, and nonunion that Charnley argued in favor of nonoperative treatment. His sentiments were soon echoed by Stewart et al. (1966) and Neer et al. (1967), who published the results of treatment of a major intraarticular fracture, the supracondylar fracture of the femur in the adult.