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The tibial plateau is the top joint surface of the shinbone and is one of the most critical load-bearing areas in the human body. So, fractures of the plateau affect knee alignment, stability and motion.
A tibial plateau fracture involves the cartilage surface of the knee joint. Because these fractures occur around the knee joint, they must be treated differently than the tibial shaft fractures.
When a fracture occurs into or around a joint surface, that joint is at high risk of developing arthritis due to the injury. Unfortunately, even if the bone and cartilage surfaces are lined up perfectly, there is still a risk of developing knee arthritis due to injury to the cartilage cells.
It is important that your doctor knows the circumstances of your injury, including how and when it occurred. After discussing your symptoms and medical history, your doctor will do a careful examination of your lower leg. After the visual inspection, your doctor will feel along your leg to see if there are abnormalities of the tibia. Your doctor will test your sensation and muscle strength by asking you to move your toes and see if you can feel different areas over your foot and ankle. Then, your doctor may order X-rays or a CT scan to examine your lower leg more closely and to confirm that it is indeed a tibial plateau fracture.
Treatment first involves the use of ice and medicine to reduce pain and inflammation. If the bone fragments are out of alignment (e.g., a displaced fracture), immediate realignment of the bone by a Kayal surgeon is required. Fractures that cannot be realigned by hand, or are open, may require surgery to hold the fracture in place with screws, pins, and plates. Once the bone is aligned, the knee should be restrained to allow for healing. You may be non-weight bearing during this period of healing. After restraint, it is important to perform strengthening and stretching exercises to help regain strength and a full range of motion.