During these surgeries injured meniscus or tendons are repaired as well. Sometimes bone graft or types of bone cement are needed to support the joint surface. The type of fracture usually dictates what types of incisions and how many plates and screws are needed. The injury is usually fixed with metal plates and screws placed through a large incision. Surgeons may recommend an operation to fix the broken tibia if the pieces are displaced, if the bone sticks out of the skin, if skin is at risk for dying or if the bone is unstable due to the fracture type. Physical therapy for knee range of motion is started around 6 weeks once bone has healed enough to prevent displacement with motion. One fall or continued lack of compliance with casting, bracing or early walking against medical advice can cause bones to move and result in the need for surgery.ĭepending on health and injury pattern this bone can take 3-4 months to heal without surgery. Cutting down or quitting smoking and tight blood sugar control if you are a diabetic is important for the healing process. If non-operative care is chosen, regular follow-up care for a physical exam and x-rays is important to ensure that the fracture stays in good position and heals appropriately. Knee immobilizers, hinged knee braces and casts are all used to treat these injuries depending on the fracture type and patient characteristics. Nonsurgical treatment is also recommended for adults with poor overall health, fragile or chronically infected skin and less active patients. Small breaks or those with good overall alignment often can be treated without an operation. Some fracture patterns and types do not need surgery for the bone to heal. Preoperative x-ray of tibial plateau fracture. Sometimes an MRI is ordered for small fractures or to help diagnose stress fractures that do not show up on plain x-rays. A CT (Computed Tomography) scan is often ordered to help plan treatment and surgery. Often 2 or more x-rays are taken to show the injury pattern. This helps doctors and patients make an informed decision on treatment. X-rays are used to evaluate the location and severity of the broken bone. These tests may feel like your doctor is trying to torture you when you already have a broken bone but this exam is very important. Signs of this syndrome are severe pain with stretch of the big toe, loss of sensation in the foot or pain out of proportion to the injury itself. Eventually, the muscle will die if this goes untreated. This occurs when the pressure in the leg gets too high for blood and oxygen to circulate. Patients with tibia plateau fractures are at risk for a serious condition called compartment syndrome. Often, the bone tries to poke out of the skin or “tent.” If this is not corrected, the skin can die or the bone can eventually cut the skin. The doctor will look for any open wounds over the injury as these usually require surgery. Diagnosis of an injury to some blood vessels requires urgent surgery. Important nerves and blood vessels run next to this bone and can be injured when it breaks. Physical examination is critical in the evaluation of these injuries. If this is disrupted, arthritis can occur. It is also covered with a layer of cartilage that allows the knee to glide smoothly. They require this bone to be strong and straight to function well. The ligaments and tendons around the knee all connect to the plateau. The tibia plateau is an important part of the knee joint because it supports your body weight as you walk, run and jump. The tibia can be broken into many pieces or just crack slightly depending on the quality of bone and the type of injury. These fractures usually result from high energy injuries such as car accidents in younger patients and most often from falls in the elderly patient. All of these structures must be taken into account when diagnosing and treating these injuries. This is an injury that can involve the bone, meniscus, ligaments, muscles, tendons and skin around the knee. Tibial Plateau Fracture What is a Tibial Plateau Fracture?Ī tibial plateau fracture is a break of the larger lower leg bone below the knee that breaks into the knee joint itself. John Zebrack, MD General Orthopedic Surgery Jeffrey Webster, MD General Orthopedic Surgery Nichole Joslyn, MD Hand & Upper Extremity Thomas Christensen, MD Hand & Upper Extremity James Christensen, MD Hand & Upper Extremity Nikola Babovic, MD Hand & Upper Extremity
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