Tibial Plateau Fractures

What is a Tibial Plateau Fracture?

The tibia is more commonly known as the shin bone, and makes up the lower portion of the knee joint. The flat part at the top of the tibia is called the tibial plateau.

The tibial plateau serves as a structural shock absorber for the knee with standing. A fracture along the tibial plateau is painful and often prevents standing or weight bear. With severe tibial plateau fractures, surgery may be needed.

X-ray image of tibial plateau fracturesX-Ray of Tibial Plateau Fracture

Causes of Tibial Plateau Fractures

Falling onto a flexed (bent) knee is the most common causes for a tibial plateau fracture. Motor vehicle accidents or injuries from contact sports such as football, hockey and rugby can also lead to fractures along the tibial plateau. Women and those with lower bone density (via osteoporosis) are more susceptible to tibial plateau fractures. 

Medical attention is usually required if you are unable to:

- walk/stand

-notice immediate swelling+ bruising around the injury site

-limited knee range of motion, or severe pain to touch along the underside of the kneecap. 

X-rays are the common diagnostic tests used to determine if a tibial plateau fracture is present after injury.

Recovery Time for a Tibial Plateau Fracture?

Recovery time for tibial plateau fractures depend on the on the extent of the injury. Less severe fractures that do not require surgery can heal in 3-4 months, however in the more extreme cases of a tibial plateau fracture where surgery is needed, this timeline can increase to 6+ months.

Treatment for Tibial Plateau Fracture

Surgery for Tibial Plateau Fractures

A 2013 study from PubMed found that surgical intervention is often the most effective way to treat tibial plateau fractures. When surgery is required, the fracture site is repaired with a procedure known as Open Reduction Internal Fixation (ORIF). During this procedure a surgeon uses screws, pins, rods and/or plates to stabilize the fracture. This will ensure that proper healing takes place along the bone and cartilage of the tibial plateau. When a patient are fully recovered, the surgeon will determine if this hardware stays in the tibia or will be removed at a later date.

ORIF surgery x-rayX-Ray of ORIF Surgery for Tibial Plateau Fracture

As mentioned above, the tibia serves as the shock absorber of the knee joint. When a tibial plateau fracture undergoes an ORIF the patient is required to stay off their feet and follow a Non-Weight Bearing (NWB) protocol. Non-weight bearing status means the standing or placing weight through the limb is not permitted. Patients who walk and will need to use crutches, wheelchair or a knee scooter for transportation. NWB status is the reason tibial plateau fractures treated with surgery take longer to recover.

Rehabilitation after Tibial Plateau Surgery

The main goal after a tibial plateau fracture is to restore function in the knee joint. For patient who undergoes surgery, rehab in the early stages on focuses on:

  • Reducing inflammation
  • Keeping pain low
  • Maintain/restoring full range of motion in the knee.

Physical therapy is crucial to avoid contractures and prevent the knee from becoming stiff. Proper Rehabilitation is vital for long-term success following a tibial plateau fracture/surgery.

As the recovery process progresses, rehabilitation varies depending on the surgeon’s protocol. Once the surgeon is confident that the fracture site has healed, the NWB status can be lifted and a more aggressive strengthening protocol can be implemented.

It is common for the quadriceps muscle to be most negatively affected following surgery on the tibial plateau. Other muscles affected include but are not limited to: 

  • Hamstrings
  • Gluteus maximus
  • Gluteus minimus

A skilled physical therapist is helpful during the strengthening phase. Physical therapy helps improve function, restore a normal gait patterns and helps patients return to pre-injury status.

Related Links:

If you have a knee injury, or are concerned about a possible Tibial Plateau Fracture, the Jacksonville Orthopaedic Institute can help. To see a JOI Orthopedic Doctor, call (904)JOI-2000, schedule online, or click the link below. To see a JOI Rehab Therapist in 1 of our 12 locations, call (904)858-7045.

By: Adam Hutchison, PT, DPT

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