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Knee

Tibial Plateau Fractures

What is the tibia?

The tibia, or shinbone, is the larger of the two bones in the lower leg. It supports most of your body weight and forms the lower part of the knee joint and the inner part of the ankle joint.

The tibial plateau is the upper surface of the tibia that meets the femur to form the knee joint. It’s divided into medial and lateral parts and is covered with cartilage to support smooth joint movement and weight-bearing.

A tibial plateau fracture is a break in the upper part of the tibia, often involving the joint surface. It can affect knee stability, alignment, and cartilage, and may lead to arthritis if not properly treated.

These fractures are typically caused by high-energy trauma like a car accident or a fall from height. In older adults, they can also occur from lower-energy injuries, especially in osteoporotic bone.

Symptoms include pain, swelling, bruising, and inability to bear weight. The knee may appear deformed or unstable. In severe cases, there may be numbness, tingling, or signs of vascular or nerve injury.

Diagnosis begins with a physical exam and X-rays. CT scans are often used to evaluate the fracture in more detail and plan surgery. MRI may be used to assess associated injuries like ligament or meniscus damage.

Compartment syndrome is a serious complication where pressure builds within the muscles, cutting off blood flow. It can occur after a tibial plateau fracture and may require emergency surgery (fasciotomy) to relieve pressure and prevent permanent damage.

Treatment depends on the severity of the fracture. Nondisplaced or stable fractures may be treated with bracing and non-weight-bearing. Displaced or unstable fractures typically require surgery to realign the bone and restore joint surface.

This surgical procedure involves making an incision to realign the broken bone fragments (open reduction), then stabilizing them with plates and screws (internal fixation). The goal is to restore the joint surface and allow early motion.

Bone graft is natural bone — often taken from the patient or a donor — used to fill a gap or support healing where bone is missing or damaged. It promotes new bone growth and helps stabilize the fracture.

Bone void fillers or substitutes are synthetic materials (like calcium phosphate or hydroxyapatite) used instead of traditional bone graft. They fill gaps in the bone and support healing, especially in areas with bone loss or crush injuries.

Recovery typically takes at least 6 months. Patients may be non-weight-bearing for several weeks to a couple of months depending on the fracture. Physical therapy begins early to restore knee motion. Full recovery, including return to sports or high-impact activities, may take 6 to 12 months depending on fracture severity and healing progress.

At a Glance

Sachin Allahabadi, MD

  • Board-Certified & Fellowship-Trained Sports Medicine Surgeon
  • Expertise in Minimally Invasive Knee & Shoulder Surgeries
  • Assistant Professor of Clinical Orthopaedic Surgery, Houston Methodist Hospital & Weill Cornell Medical College
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