What is an Osteochondral Fracture

Osteochondral fracture is break or tear (rupture) in the protective tissue that cushions bones in the joints (articular cartilage).

Osteochondral fractures most commonly happen in the knees or ankles, but they can also happen in other parts of the body.

What are the causes?

This condition is caused by a forceful hit to your joint. It can be caused by one event or from repetitive damage to your joint over time.

What increases the risk?

This condition is more likely to develop in:

• Children and adolescents.
• Athletes.

What are the signs or symptoms?

Symptoms of this condition include:

• Swelling.
• Pain.
• A crackling sound (crepitation) when you move the joint.
• Difficulty moving the joint, or a “catching” or “locking” feeling when you try to move it.
• Instability of the joint.

How is this diagnosed?

This condition is diagnosed based on:

• Your complete medical history.
• The events that led to the injury.
• A physical examination.
• Imaging tests such as an X-ray, a CT scan, or MRI.

How is this treated?

This condition may be treated with:

• Ice and medicine. These help with pain and inflammation.
• Crutches. These help with walking. They may be needed if the injured joint is in one of the legs.
• A restraint. This keeps the cartilage and bones in place so they can heal.
• Surgery. This may be done if other treatments do not work. During the surgery, any bones that have broken off will either be put into place or be removed if they cannot be reattached.
• Joint and muscle exercises. These help to strengthen and stretch the affected joints and muscles. They may be done at home or with a therapist.

If treated properly, symptoms go away in most cases.

Follow these instructions at home:

If you have a cast:

• Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
• Check the skin around the cast every day. Report any concerns to your health care provider. You may put lotion on dry skin around the edges of the cast. Do not apply lotion to the skin underneath the cast.
• Do not let your cast get wet if it is not waterproof.
• Keep the cast clean.

If you have a splint:

• Wear the splint as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the splint if your fingers or toes become numb and tingle, or if they turn cold and blue.
• Do not let your splint get wet if it is not waterproof.
• Keep the splint clean.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
• If your cast or splint is not waterproof, cover it with a watertight plastic bag when you take a bath or shower.

Managing pain, stiffness, and swelling

• If directed, apply ice to the injured area.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times per day.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.
• Take over-the-counter and prescription medicines only as told by your health care provider.

Driving

• Do not drive or operate heavy machinery while taking prescription pain medicine.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Perform exercises daily as told by your health care provider or physical therapist.
• Follow instructions from your health care provider about how much weight you can carry.

General instructions

• Do not put pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
• Do not use any tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your pain gets worse after treatment.

Get help right away if:

• You have severe pain.