Tibial Plateau Fracture
The tibial plateau is the top surface of the tibia, or shin bone, made of cancellous, or cartilage-like bone. A tibial plateau fracture is often the result of a fall, or a sports-related or a traumatic injury. Fractures that involve the tibial plateau often occur when an injury pushes the lower end of the thighbone (femur) into the soft bone of the tibial plateau, causing the soft cancellous bone to compress and remain sunken. A fracture may also cause the bone to break into two or several pieces. An injury to the tibial plateau is especially distressing on the body, as the majority of standing body weight rests on this bone. Fractures of the tibial plateau affect the alignment, stability and movement of the knee.
Symptoms of a Tibial Plateau Fracture
Symptoms of a tibial plateau fracture may include:
- Swelling of the knee
- Pain that worsens when weight is applied
- Numbness in the leg or foot
- Deformed appearance of the knee
If the foot of the injured leg appears pale in color or cool to the touch, it may be a sign that blood circulation is impaired.
Diagnosis of a Tibial Plateau Fracture
A tibial plateau fracture is diagnosed after a physical examination of the knee and leg as well as imaging tests that may include X-rays, CT scans or MRI scans. Imaging tests allow the physician to identify the exact location of the fracture and determine whether the fracture is considered displaced.
Complications of a Tibial Plateau Fracture
Severe swelling of soft tissue caused by a tibial plateau fracture, may cause a rare and serious condition known as compartment syndrome to develop. Compartment syndrome can affect the blood supply to the muscles and nerves in the leg and foot. This condition may require an emergency surgical procedure, known as a fasciotomy. During a fasciotomy, incisions are made to release the skin and muscle coverings and reduce swelling.
Treatment of a Tibial Plateau Fracture
Treatment for a tibial plateau fracture may vary based on the severity of the injury and may include:
- Immobilization through a cast or brace
- Pain medication
A displaced tibial plateau fracture may require the broken bones to be realigned, prior to casting. Depending on the degree of displacement, surgical or nonsurgical methods may be used to manipulate the bones back into position. Severe or multiple fractures may require external fixation, which uses an outer metal rod and pins to hold the bone or bones in place until they heal. Internal fixation devices, including plates, rods or screws, may also be used to maintain proper position of the bone during healing.
Weight bearing activities may be extremely limited while recovering and it may take up to 3 months of healing before full weight bearing can be done safely. As the bones heal, physical therapy is recommended to restore normal muscle strength, range of motion, and stability.