[Infected joint fracture. Diagnosis, treatment and results in 63 patients]

For diagnosis, treatment and prognosis of infected articular fractures special attention should be paid to the following: When conventional treatment with puncture and irrigation of the joint after a maximum of 7 days is not successful, synovectomy in the early stage of infection, before extensive cartilage destruction particularly in the knee, elbow joint and hand, is the appropriate treatment. The progressive destruction of the cartilage and bone is interrupted. As a result of the early functional after-treatment good mobility of the joint and cartilage nutrition are achieved. In patients who were treated with synovectomy the time for healing was only 4 months, after arthrectomy 7 months and arthrodesis 20 months. Taking into consideration the complaints, mobility and shortening of the leg synovectomies had better results. The overall result demonstrates that despite enormous therapeutic effort, the infection in articular fractures is a serious complication which often leads to permanently functional deficiencies. Of 55 re-examined patients 34 were free of complaints, 5 amputations were necessary as a result of severe neurovascular damage and sepsis. The best results were achieved with early synovectomy.