Fractures can result in several long term or permanent complications that can necessitate additional surgical procedures. One of the most common long term debilitating complications is traumatic arthritis. Traumatic arthritis can affect almost any moveable joint in the body. To explain traumatic arthritis more in depth, we will be focusing on the tibiotalar (ankle) joint, as shown in the illustration to the right.
As like most moveable joints, the tibiotalar joint consists of smooth articular bone covered by thick, shock-absorbing articular cartilage.
During trauma, the joint surfaces can be driven together resulting in injuries to the cartilage and microfractures of the articular surface (even without obvious intrarticular fracture).
The bone and cartilage then undergo changes that result in the progressive breakdown of the joint. As the process advances, the joint becomes painful. In most cases, the only treatment options are joint replacement or fusion.
The acromioclavicular (AC) joint also frequently falls victim to traumatic arthritis. As the AC joint enlarges (hypertrophy) it impinges on the rotator cuff, which is referred to as subacromial impingement. This can cause irritation or tearing of the rotator cuff and is most often treated by AC joint resection and subacromial decompression.