PROGRESS IN THE TREATMENT OF ARTICULAR FR ACTURES AND LIGAMENT INJURIES

The treatment of joint injuries has seen a marked development in the l ast years. The surgical trauma of articular reconstruction was reduced and our deeper understanding of the mechanism of connective tissue he aling influenced the rehabilitation program after joint injuries signi ficantly. Indirect soft-tissue sparing reduction techniques can be app lied to most joint fractures and improved fixation techniques using in traoperative fluoroscopy or arthroscopy allow to avoid vast exposures of the joint. The process of ligament healing requires joint movement and a certain stress to the healing tissue in order to achieve optimum scar strength, stiffness and remodeling. Immobilisation thus should b e avoided completely after ligament injuries and certain lesions can b e treated non-operatively with a high success rate (MCL rupture, ankle sprain, elbow dislocation). In other injuries, surgery should stabili ze the joint thus allowing functional rehabilitation (cruciate ligamen t tears, shoulder dislocation).