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
Classification of Tibial Plateau Fractures
- Schatzker Type I: A wedge fracture of the lateral tibia plateau with displacement or depression
- Schatzker Type II: A fracture of the lateral tibia plateau with depression and splitting
- Schatzker Type III: A compression fracture of the central or lateral tibia plateau with depression
- Schatzker Type IV: A fracture of the medial tibial plateau with a depressed or split component
- Schatzker Type V: A wedge fracture of both medial and lateral tibial plateau
- Schatzker Type VI: A transverse fracture of the tibial plateau with discontinuity of diaphysis (the midsection of the tibia)
- 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
- 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
- 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 any damage present in the internal hard and soft tissue structures of the body.
- 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 detect the variation in pulse rate in cases with arterial injury.
Treatment for Tibial Plateau Fracture
- 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 pain-relievers and 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 if conservative treatment measures do not help and may involve 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.