What is a Tibial Plateau Fracture?
A tibial plateau fracture is a crack or break on the top surface of the tibia or shinbone in the knee joint. The fracture most often occurs following a high-intensity trauma or injury from the impaction of the femoral condyles over the tibial plateau. Fractures of the tibial plateau are serious injuries that are more commonly seen in athletes involved in high-impact sports such as basketball, rugby, and football and can put athletes out of action for a long period of time.
Anatomy of Tibial Plateau
The knee is a hinge joint made up of 2 bones, the thighbone (femur) and shinbone (tibia). There are 2 round knobs at the end of the femur called femoral condyles that articulate with the flat surface of the tibia called the tibial plateau. This is a crucial weight-bearing segment of the body that attaches the thighbone to the shinbone through tough bands of tissue called ligaments. The tibial plateau on the inside of the leg is called the medial tibial plateau and on the outside of the leg, the lateral tibial plateau. The lateral side is more prone to fracture than the medial side.
Causes and Risk Factors of Tibial Plateau Fracture
Some of the causes of a tibial plateau fracture include:
- Motor vehicle collisions
- Fall from a height
- Injuries from high-intensity sports, such as skiing or football
- Bone infection
- Bone mineral deficiency
Signs and Symptoms of Tibial Plateau Fracture
Some of the signs and symptoms of a tibial plateau fracture include:
- Persistent pain in the knee joint
- Swelling and bruising
- Inability to bear weight on the legs
- Decreased range of motion in the knee
- Paleness in the leg due to reduced blood flow
Diagnosis of Tibial Plateau Fracture
To diagnose a tibial plateau fracture, your doctor will review your symptoms and medical history and conduct a thorough physical examination to look for signs of swelling, bruises, rupture of the skin, instability, and other deformities. In order to confirm the diagnosis and obtain further information on the severity of the fracture, your doctor may recommend:
- X-rays: This study uses high electromagnetic energy beams that produce images of the bones to help detect fractures.
- CT Scan: This scan uses special X rays that produce clear images of the bone in three dimensions
- MRI Scan: This study produces images that help in detecting damage to soft tissues or ligaments using large magnetic fields and radio waves.
- CT angiography: This test is done to assess the integrity of blood vessels in cases with suspected arterial injury.
Treatment for Tibial Plateau Fracture
Treatment for a tibial plateau fracture depends upon the classification of the fracture and involves both conservative as well as surgical options. These treatment options include:
- Rest: Providing ample rest to the injured knee and avoiding activities that trigger symptoms
- Ice: Application of ice packs on the joints to decrease swelling and pain
- Compression: Compressing the affected area with elastic bandages to reduce pain and swelling
- Elevation: Keeping the leg elevated above chest level helps to decrease any swelling
- Medications: Use of anti-inflammatory medications, such as naproxen and ibuprofen to control pain and inflammation
- Orthotics: Use of assistive devices such as knee braces and splints to avoid weight on the injury and prevent any damage to the joint surface
- Surgery: Surgical intervention may be required and involves the use of plates and screws to realign the bone to confer stability to the joint. Recovery post-surgery may take anywhere from 3 to 6 months and varies from individual to individual depending on the severity of the tibial plateau fracture.