Orthopaedic trauma mythbusters: intra-articular fractures

Intra-articular fractures of the tibial plateau, pilon, and calcaneus often present a challenge for the treating orthopaedic surgeon. These injuries can have substantial comminution in the joint and the metaphyseal areas and are often accompanied by considerable soft-tissue trauma. In recent years, several questionable beliefs concerning these fractures have emerged and are best considered as myths. These myths include the beliefs that most patients with intra-articular fractures will have poor outcomes even with good surgical treatment, severe intra-articular fractures require a later reconstructive procedure regardless of the treatment, and the surgical treatment of comminuted intra-articular fractures has a high complication rate and may result in infection and limit the available options for limb salvage. A review of the literature regarding the treatment of common intra-articular fractures is helpful in determining if these myths concerning treatment options can be confirmed or disproved.