The tibial plateau is the upper surface of the tibia (shinbone), composed of cancellous bone, which is spongy and cartilage-like. A tibial plateau fracture typically occurs as a result of a fall, sports injury, or other traumatic events. These fractures often happen when the lower end of the thighbone (femur) impacts the tibial plateau, forcing the femur into the soft bone of the tibia, causing compression or a depression of the bone. In more severe cases, the tibial plateau may break into multiple pieces.

Injuries to the tibial plateau are particularly concerning due to the significant role this bone plays in supporting body weight while standing. These fractures can compromise the alignment, stability, and movement of the knee joint, making them potentially debilitating.

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Symptoms of a Tibial Plateau Fracture

A tibial plateau fracture may present with the following symptoms:

  • Swelling around the knee
  • Pain that intensifies when weight is applied
  • Numbness in the leg or foot
  • Deformed appearance of the knee
  • Paleness or coolness in the foot of the injured leg, which may indicate impaired blood circulation

Diagnosis of a Tibial Plateau Fracture

A tibial plateau fracture is diagnosed through a physical examination of the knee and leg, alongside imaging tests such as:

  • X-rays
  • CT scans
  • MRI scans

These imaging tests help determine the exact location of the fracture and whether it is displaced.

Complications of a Tibial Plateau Fracture

A serious complication that may arise from a tibial plateau fracture is compartment syndrome. This condition occurs when severe swelling affects the blood supply to the muscles and nerves in the leg and foot. Compartment syndrome requires emergency surgery (fasciotomy), where incisions are made to relieve the pressure by opening up the skin and muscle coverings.

Treatment of a Tibial Plateau Fracture

The treatment plan for a tibial plateau fracture depends on the severity of the injury and may include:

  • Rest and immobilization with a cast or brace
  • Pain medication to manage discomfort
  • For a displaced fracture, the bone fragments may need to be realigned before casting. Surgical or nonsurgical methods may be used to reposition the bones.
  • Severe fractures may require external fixation, using metal rods and pins to stabilize the bones, or internal fixation with plates, screws, or rods.

During recovery, weight-bearing activities will be highly restricted, and it may take up to 3 months for the bone to fully heal. Physical therapy is crucial to regain strength, range of motion, and stability as the bone heals.

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