Tibial Plateau Fracture
Overview of Tibial Plateau Fracture
The top surface of the tibial plateau, or shinbone, is cancellous, or mesh-like. When damaged, it affects the knee, the largest weight-bearing joint of your body, causing intense pain and greatly impairing motion and stability.
Causes of Tibial Plateau Fracture
Although tibial plateau fractures may sometimes occur with osteoporotic bone changes, they more likely result from a high impact hit to the area, seen in sports such as basketball, football, and rugby; motor vehicle accidents; an unintended twist to the area; or a fall from a considerable height.
Symptoms of Tibial Plateau Fracture
Common symptoms of a tibial plateau fracture include:
- Inability to put weight on the injured area
- Deformity of the leg
- Instability of the leg
- Bone noticeably protruding from under the skin
- Gray colored/cool-to-touch foot
- Numbness/ “pins and needles” in or around the foot
Diagnosis of Tibial Plateau Fracture
Without timely intervention, a tibial plateau fracture may result in your limb’s improper alignment, as well as long-term complications such as loss of motion, arthritis, and instability.
Also, the break may be further complicated by soft tissue injuries of the blood vessels, ligaments, muscles, nerves, and skin.
In diagnosing your injury, your orthopaedist will ask you how and when it occurred; if other injuries were incurred at the time; your medical problems/history; and current medications.
A visual and physical “touch” examination of the leg will allow your orthopaedist to note breaks in the skin, bruises, swelling, or obvious deformities not present before the injury, and the existence and/or degree of any instability of the leg.
Other tests that may help your orthopaedist in the diagnosis are X-rays and CT (computed tomography) scans to confirm that the bone is broken and if a gap between bones exists. The CT scan also provides a cross-sectional image for ascertaining the fracture’s severity.
Tibial Plateau Fracture Treatment
In some individuals, surgery may be of limited benefit. Your current medical condition/ history or pre-existing conditions might make it likely that the risks would outweigh the benefits.
If yours is a closed fracture of the bone involving only two major fragments and minor displacement, use of a splint or a full and (later functional) cast may be an option.
The goal of tibial plateau fracture surgery to restore optimal range of motion by reestablishing alignment, stability, and continuity of the joints.
Should you be a candidate, your orthopaedist will base his or her recommendations on the following:
- Type of injury
- Injury-caused open wound that requires monitoring
- Number of bone fragments involved
- Degree of displacement
- Your lifestyle/personal wishes
If you are active, surgery is often a good choice, as it will increase stability and motion of the joint and help minimize the likelihood of developing arthritis in the future.
There are several types of surgical procedures that can be employed: intramedullary rods/nails; plates and screws; and external fixation. Your orthopaedist will decide which of these best suits your case, explaining it in whatever detail you request.
Tibial Plateau Fracture Surgery Recovery
Recovery time is commonly four to six weeks, depending on the type of fracture and your body’s natural ability to heal.
Pain, a natural part of the healing process, will be monitored by your healthcare team, who will keep it to a minimum by prescribing short-term pain medications, along with non-steroidal anti-inflammatory drugs, local anesthetics, opioids (with caution) or whatever combination allows you to be comfortable.
Leg motion is often encouraged soon after the surgery, as muscle strength in the affected area fades quickly.
Physical therapy and exercise before and after your cast is removed will shorten the progression of your recuperation and help you more quickly regain your muscle strength, flexibility, joint motion, and confidence.