Displaced Tibial Plateau Fracture

What is a displaced tibial plateau fracture, and how is it treated?

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What Is a Tibial Plateau Fracture?

The tibial plateau refers to the upper part of the shin bone called the tibia. The bone in this area is cancellous or crunchy. 

This is a different composition from the rest of the tibial shaft, which is a thicker cortical bone. In addition, because the tibial plateau is made of cancellous bone, it may compress and remain compressed following an injury.

Fractures in the upper quarter of the lower leg may or may not involve the knee joint. If the fracture enters the knee joint, it may result in an imperfect joint, and the joint surface will become irregular. 

There is also a possibility that these fractures will result in improper limb alignment.


About Displaced Tibial Plateau Fractures

When a tibial plateau fracture occurs, you may also injure the soft tissues surrounding the knee. This could include the skin, muscles, nerves, blood vessels, or ligaments.

Your orthopedic surgeon will check to see if you have any soft-tissue damage and include this in his treatment.

What Causes a Tibial Plateau Fracture?

Tibial plateau fractures occur from stress (stress fractures resulting from unusual excessive activity), from bone that was already compromised (such as in cancer or infection), or, as is most commonly the case, as a result of trauma (injury).

A young person may have a fracture due to a high-energy injury. Possible causes could include a fall from a considerable height, a sports-related injury, or a motor vehicle accident. 

These result in the most severe fractures. 

An older person may fracture their tibial plateau with only a low-energy injury. This is because they generally have a lower bone density. 

The fracture may result from a fall from a standing position. Other risk factors include osteoporosis, infection, or mineral deficiency that weakens the bones and makes them susceptible to injury.

Types of Tibial Plateau Fractures

Tibial plateau fractures are classified into six different types. Usually, the higher the energy of the impact, the greater the severity of the break.

Schatzker classification for tibial plateau fracture:

Type I – Lateral tibial plateau fracture without depression.

Type II – Lateral tibial plateau fracture with depression

Type III  Focal depression of articular surface with no associated split. A type of pure compression fracture 

Type IV – Medial tibial plateau fracture, with or without depression; may involve tibial spines; associated with soft tissue injuries. It has a split or depressed component

Type V – Bicondylar tibial plateau fracture or wedge fracture

How Do You Treat a Tibial Plateau Fracture?

Emergency Care

In some instances, the swelling can be so severe that the blood supply to the leg and foot is drastically reduced. This is referred to as compartment syndrome. 

Emergency surgery may be needed to allow proper blood flow to resume. The orthopedic surgeon will make vertical incisions in the skin and muscle coverings, and these will be left open until the swelling is reduced.

In this case, the condition of the soft tissues would not allow for a splint to be used to secure the knee. Instead, an external fixator may be used. 

External fixation involves stabilizing the knee by inserting pins below and above the joint.

Non-surgical Treatment

The most common non-surgical treatment is a short leg, non-weight bearing cast, or a hinged knee brace with rest. This will be followed by physical therapy as the injury allows.

Surgical Treatment

You may require surgery if there is a need to recover and maintain alignment. Internal fixation with rods and plates may be used to stabilize a fracture. 

If the fracture enters the joint and depresses the bone, the bone fragments may need to be lifted. This can leave a space below the bone.

A bone graft may be used to fill space and support the joint, preventing it from collapsing.

If you have a severe knee injury or chronic knee pain that reduces your mobility or quality of life, contact OrthoNeuro to schedule a consultation.

Our expert orthopedic surgeons are on hand to diagnose and treat your knee problem.

Make an Appointment with an OrthoNeuro Knee Specialist Today!

If you have been suffering from a displaced tibial plateau fracture, schedule an appointment with one of our Board Certified Orthopedic Surgeons at one of our 7 convenient locations throughout Greater Columbus

We will evaluate your unique lifestyle and goals to determine which type of treatment is best for you.

Knee Specialists

If you have a severe knee injury or chronic knee pain that reduces your mobility or quality of life, contact OrthoNeuro to schedule a consultation. Our expert orthopedic surgeons are on hand to diagnose and treat your knee problem.

Michael B. Cannone, DO

Orthopedic Surgeon

Mark E. Gittins, DO, FAOAO

Orthopedic Surgeon

Ryan M. Palmer, DO

Orthopedic Surgeon

B. Rodney Comisar, MD, FAAOS

Orthopedic Surgeon

Mark T. Kolich, D.O.

Orthopedic Surgeon

Keith A. LaDu, DO

Orthopedic Surgeon

Jeremy R. Mathis, DO

Orthopedic Surgeon

Meniscus repair six months ago. Surgery went smoothly. Dr. set realistic expectations that have been met. Great team to work with