The tibial plateau most commonly fractures following high-energy trauma, such as a fall from height or a road traffic accident, from the impaction of the femoral condyle onto the tibial plateau. Less commonly they occur in elderly patients following a fall, especially those with osteoporosis.
The upper surface of the tibia or shinbone is called the tibial plateau. If you engage in activities such as horse riding, skiing, and certain water sports, you are likely to get a tibial plateau fracture.
Since the tibial plateau contains certain structures essential for proper functioning of your knees, a fracture to this area may lead to some serious consequences. Fractures of the tibial plateau are usually associated with injuries to the collateral ligaments (LCL or MCL), anterior cruciate ligament, menisci and articular cartilage.
It is possible to repair the damage, but the injury can lead to the early onset of osteoarthritis. Moreover, you need to be careful during tibial plateau fracture recovery to ensure you do not have to deal with serious complications.
How do you know you have Tibial Plateau fracture
A fracture to your shinbone may also injure the bone as well as the soft tissues associated with your knee. Some common symptoms of a tibial plateau fracture include the following:
- You may experience pain when you bear weight on the injured leg.
- You may notice some tension around your knee; it may be difficult to bend your knee completely.
- You may have deformity around your affected knee, but the leg may look normal.
- You may notice your foot look pale or feel cold after the injury.
- You may notice numbness around your foot after the injury.
If you have any of these symptoms, it is important to talk to your doctor immediately for further evaluation.
Types of Tibial Plateau Fracture
Tibial plateau fractures can be divided into two different categories – non-displaced and displaced tibial plateau fracture. Here is more about these types:
You have this type of fracture when the tibia has sustained a crack or break but no fragment of the bone has separated. Tibial plateau fracture recovery is relatively easier in this case – it does not require surgical intervention and may heal within 3-4 months. You just need to ensure that you do not bear any weight on your affected leg and wear a knee brace as well.
In this type of fracture, there will be some fragments separating from the tibia. You usually require surgical intervention to fix the problem – your doctor will use screws and plates to re-fix those fragments. It takes several months to recover from this type of injury.
Tibial Plateau Fracture
There are both surgical and non-surgical treatment options available, and your doctor will check your symptoms and the severity of your fracture to determine the best treatment approach in your case.
It involves following the P.R.I.C.E approach – it means you have to Protect your affected area; give it enough Rest; use Ice packs; keep it Compressed; and Elevate it. You need to ensure that you do not put any weight on your injured leg and keep wearing a hinged knee brace for as long as your doctor recommends. It is also important to avoid limb immobilization or it would lead to knee stiffness.
You usually need surgery for displaced fractures, open fractures, and fractures that change the mechanical alignment of your limb. Your doctor may use one of two approaches to treat your fracture surgically.
They may opt for external fixation that involves using metal wires and pins to promote distraction and reduction of the fracture. They may also use another technique that involves using plates and screws to re-fix the fracture and bone fragments.
Depending on how serious the fracture is, your doctor will make an incision in the skin and use metallic screws to reduce and fix the fracture fragments.
Once you have sustained the injury or undergone surgery, you need to pay special attention to recovery. There are certain things you should or should not do during this phase. Here is more about it.
1. Pain Management
It is obvious to feel pain after your surgery or injury, but you can certainly take steps to manage it better. Your doctor may prescribe painkillers that you have to take on a short-term basis only. They may give you non-steroidal anti-inflammatory drugs, opioids, or local anesthetics to help reduce pain. You should be using opioids carefully because they are narcotic and may be addictive.
2. Early Motion
Your doctor will confirm when you should start putting pressure on your leg and get moving again. It is important to start moving your knee at the right time to prevent knee stiffness. You will have to work with a physical therapist to learn about some passive exercises, which will help strengthen your knee. Sometimes, they will decide to place your knee in a continuous motion machine – the machine will keep your leg moving to prevent stiffness.
3. Weight Bearing
Do not start putting weight on your leg before consulting your doctor. If your fracture has not healed enough, you may aggravate it by putting weight on it too early. In most cases, you should avoid full weight bearing for at least 3 months.
It is important to learn how to use crutches during your recovery phase. You may also have to wear a knee to avoid aggravating your injury. Your doctor will use x-rays to monitor your tibial plateau fracture recovery. These x-rays also help your doctor know if the bone is changing position. They will let you put more weight on your leg once they are sure that your fracture will not change position.
Know that you are going to feel very weak after your doctor tells you to start putting more weight on your leg. Your leg may feel stiff and unsteady as well. However, you should talk to your doctor if you have any concerns.
Your physical therapist will work with you through the rehabilitation process. Keep in mind that your commitment to physical therapy will make a big difference in how long it takes you to recover completely. If you smoke, it is a good idea to quit smoking because it interferes with the healing process.