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The major goal of the treatment of a tibial plateau fracture is to achieve a stable, aligned, mobile and painless joint, and to minimize the risk of post-traumatic osteoarthritis. The clinical history, trauma mechanism, age and associated comorbidities influence the treatment decisions.
What are the treatment goals for a tibial plateau fracture?
Some authors have also suggested that primary total knee arthroplasty could be an option in specific patients and with specific fracture patterns. Cite this article: Prat-Fabregat S, Camacho-Carrasco P. Treatment strategy for tibial plateau fractures: an update. EFORT Open Rev2016;1:225-232. DOI: 10.1302/2058-5241.1.000031.
Is primary total knee arthroplasty an option for patients with tibial plateau fractures?
The following surgical procedures are most commonly used to treat tibia fractures: external fixation, which connects screws or pins in the fracture to a metal bar outside your leg for added stability Typically, these surgical methods are accompanied by physical therapy, at-home exercises, and pain medication.
What are the treatment options for a broken tibia?
Injuries to other structures about the knee are commonly associated with tibial plateau fractures. Meniscus tears as well as injuries to the articular cartilage commonly occur in the setting of tibial plateau fractures. Fractures of the lateral tibial plateau have a rare, but possible association with nerve (peroneal) and arterial injuries.
What is the most common injury associated with tibial plateau fractures?
How long does it take to walk again after a tibial plateau fracture?
If you had surgery for your tibial plateau fracture, you can put a little bit of weight on the leg after 6 weeks with the goal of walking normally by the 10th week. If you did not have surgery for your tibial plateau fracture, you can start walking safely with a knee brace in 4-6 weeks.
How long does a lateral tibial plateau fracture take to heal?
Depending on health and injury pattern this bone can take 3-4 months to heal without surgery. Physical therapy for knee range of motion is started around 6 weeks once bone has healed enough to prevent displacement with motion.
Can you fully recover from a tibial plateau fracture?
We conclude that there is significant impairment of movement and muscle function after fracture of the tibial plateau and that the majority of patients have not fully recovered one year after injury. Loss of movement and reduced muscle function affects recovery after intra-articular fractures.
How do you rehab a tibial plateau fracture?
0 to 1 week:Ice and modalities to reduce pain and inflammation.Use crutches non-weight bearing for 6 weeks.Brace for 6 weeks in full extension.Elevate the knee above the heart for the first 3 to 5 days.Initiate patella mobility drills.Begin full passive/active knee range of motion exercises.More items...
Should I wear a knee brace after tibial plateau fracture?
Symptoms post tibial plateau fracture surgery After your surgery you will be required to wear a cast or knee brace for as long as it is necessary until there has been sufficient healing of the fracture. Your leg will be maintained in extension to ensure healing of the surgical incision.
What is the long term effects of tibial plateau fractures?
Tibial plateau fractures are intra-articular fractures that are thought to be associated with long-term risk for posttraumatic arthritis.
How do you bend your knee after tibial plateau fracture?
2:244:14What does surgery and rehab of a tibial plateau fracture entail?YouTubeStart of suggested clipEnd of suggested clipBut usually we allow the knee to bend right away for one thing the knee gets really stiff reallyMoreBut usually we allow the knee to bend right away for one thing the knee gets really stiff really quickly if you keep it basically at a knee immobilizer.
What is the fastest way to heal a broken tibia?
The three key steps to faster bone healing are:Alignment of the broken bone fragments.Stability and support at the fracture site through immobilization.Healthy lifestyle choices that promote healing.
How long does it take for a tibial plateau fracture to heal without surgery?
Non-displaced tibial plateau fracture This type of fracture normally has a better outcome than displaced fractures and heals without surgical intervention within 3-4 months. Physical therapy rehabilitation exercises are necessary to maintain leg strength.
Do you need a cast for a tibial plateau fracture?
Tibial Plateau Fracture Care For fractures that have not shifted, surgery may not be needed. The most common non-surgical treatment is a short leg, non-weightbearing cast or a hinged knee brace, combined with physical therapy and rest.
What kind of brace is used for a tibial plateau fracture?
Nondisplaced fractures of the tibial plateau can often be treated non-operatively with a period of non-weight bearing with a hinged knee brace. Any period of limb immobilization should be kept brief as knee stiffness must be avoided.
What is the procedure to fix a fractured tibia?
The following surgical procedures are most commonly used to treat tibia fractures: internal fixation, which involves using screws, rods, or plates to hold the tibia together. external fixation, which connects screws or pins in the fracture to a metal bar outside your leg for added stability.
How long does it take to recover from a tibia fracture?
Tibia fractures are painful and common. Recovery rarely requires more than 12 months. If you suspect you have a tibia fracture, schedule an appointment with your doctor right away to get it evaluated, or go to an emergency room. Last medically reviewed on November 7, 2016.
What is the classification of a fractured tibia?
Doctors often classify tibia fractures into the following categories: The broken ends of the tibia line up correctly and stay in place during the healing process. The fracture is horizontal, and the bone can become unstable if the fibula is also broken. The tibia is moved out of place when it breaks.
How long does it take for a fractured tibia to heal?
Some shaft fractures of the tibia take as little as four months to heal, with more extreme cases taking a minimum of six months to heal. Your overall health and the extent of your fracture will influence your recovery time.
What is the name of the bone that is the largest in the lower leg?
The tibia , or shinbone, is the larger of the two bones in the lower leg. It’s one of the most commonly fractured bones in the body. Symptoms of a fracture in your tibia can range from bruising to intense pain in your lower leg, based on the extent of your injury. To diagnose this type of injury, your doctor will do a physical exam ...
What causes a tibia fracture?
Twisting motions, such as pivoting: Sports such as snowboarding, skiing, and contact sports are a common cause of this type of injury. Some health conditions may also affect your tibia fracture. These include type 2 diabetes and pre-existing bone conditions such as osteoarthritis.
What is the bone in the lower leg called?
swelling around the site of your injury. bruising and blueness on your injured leg. When the tibia is fractured, the other bone in the lower leg, called the fibula, is often affected as well.
What happens if you don't correct a tibia plateau fracture?
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. Patients with tibia plateau fractures are at risk for a serious condition called compartment syndrome.
Why is the tibia plateau important?
The tibia plateau is an important part of the knee joint because it supports your body weight as you walk, run and jump. The ligaments and tendons around the knee all connect to the plateau. They require this bone to be strong and straight to function well.
What is plateau fracture?
A tibial plateau fracture is a break of the larger lower leg bone below the knee that breaks into the knee joint itself. It is rare to only just break the bone. This is an injury that can involve the bone, meniscus, ligaments, muscles, tendons and skin around the knee. All of these structures must be taken into account when diagnosing ...
How is a fracture fixed?
The injury is usually fixed with metal plates and screws placed through a large incision. The type of fracture usually dictates what types of incisions and how many plates and screws are needed. Sometimes bone graft or types of bone cement are needed to support the joint surface.
How long after tibial fracture can you get physical therapy?
Gradually this motion is increased and physical therapy is begun around 6 weeks after surgery if the patient has residual knee or ankle stiffness. Your doctor may decide to put you on a blood thinner after surgery for 2-6 weeks depending on your risk factors. Post-Op Tibial Plateau Fracture.
How long do you need to use a walker after knee replacement?
They cannot bear weight immediately. Patients will need to use a walker or crutches for the first 6 weeks. Gentle motion of the knee is begun early to prevent stiffness.
Why do you need an MRI for stress fractures?
Sometimes an MRI is ordered for small fractures or to help diagnose stress fractures that do not show up on plain x-rays.
What is a tibial plateau fracture?
Tibial plateau fractures are the most common intra-articular fractures, which require careful evaluation and preoperative planning. The treatment of tibial plateau fractures in elderly patients is challenging, and the comprehension of epidemiology and morphology can be helpful. This study described the characteristics of geriatric tibial plateau fractures.
How common are TPF fractures?
Tibial plateau fractures (TPFs) are relatively common, accounting for approximately 1% of all fractures, and the population-based incidence of TPFs has been reported as 10.3–13.3 per 100,000 people annually [ 1, 2 ]. Cases of TPFs were most common between the ages of 30 years and 60 years [ 3, 4 ]. However, with improved life expectancy, incidences of TPFs in elderly patients are probably rising [ 5, 6 ]. Comprehension of the epidemiology and morphology can be helpful to manage the fractures, but there is little epidemiological information available and to date virtually none about the morphology of TPFs focusing on the elderly population [ 6, 7 ]. This current study reports the basic epidemiology and morphological classification of TPFs in elderly patients in a level one trauma center, including incidence, injury mechanisms, combined injuries, and fracture classifications.
How long did TPFs last?
The study included all patients treated for TPFs over a 4-year period (from January 2013 to November 2016) in the trauma center of our hospital, which is a level one trauma center. Patients were excluded based on the following criteria: (1) isolated avulsion fracture of tibial plateau, such as tibial avulsion fractures of anterior or posterior cruciate ligament, Segond fractures; (2) suspected fractures which could not be confirmed by X-ray radiographs or computerized tomography (CT) scans; (3) fractures in children and skeletally immature adolescents; and (4) pathological or old fractures, namely, the fractures for more than 3 weeks. Finally, 1407 patients with TPFs were included and 327 elderly patients aged ≥ 60 years (23.24%) were isolated for further analysis.
Do elderly people have tibial plateau fractures?
The majority of elderly patients with tibial plateau fractures are females, and the population involved was increasing. Electric-bike accidents are an important cause of injury. Geriatric tibial plateau fractures have unique distribution in classification.
What is a tibial plateau fracture?
Tibial plateau fractures are complex injuries produced by high- or low-energy trauma. They principally affect young adults or the ‘third age’ population. These fractures usually have associated soft-tissue lesions that will affect their treatment. Sequential (staged) treatment (external fixation followed by definitive osteosynthesis) ...
What is a posterior shearing fracture?
The posterior shearing fracture,16an articular depression in the posterior column with a break of the posterior wall, is a ‘one-column (posterior column) fracture’ (not included in Schatzker classification). There are two common types of two-column fractures.
Is TKA a complication of osteoarthritis?
TKA can be the primary treatment of complex patterns in specific third-age patients. Osteoarthritis is a frequent complication of these fractures. Patients suffering a tibial plateau fracture should be aware of the residual pain and functional limitations that can appear in the mid- and long-term. Footnotes.
Can a tibial plateau fracture be operated on?
In general, tibial plateau fractures are to be operated on, but the decision whether to operate or not on a specific fracture should be based on the fracture morphology, the soft tissues and the patient’s general condition, and the expected limb axis and articular surface restoration.
What is a tibial plateau fracture?
It is a serious type of knee injury that can affect all types of men and women athletes.
What are the injuries associated with tibial plateau fractures?
Injuries to other structures about the knee are commonly associated with tibial plateau fractures. Meniscus tears as well as injuries to the articular cartilage commonly occur in the setting of tibial plateau fractures. Fractures of the lateral tibial plateau have a rare, but possible association with nerve (peroneal) and arterial injuries. Fractures of the medial tibial plateau can sometimes signify a knee dislocation that has spontaneously reduced. High energy tibial plateau fractures, particularly those that extend into the diaphysis, or shaft, can also be associated with compartment syndrome, which is a potentially limb threatening condition caused by increased pressure within the leg.
What are the complications of tibial plateau fracture?
Several complications are associated with the nonoperative and operative treatment of tibial plateau fractures. With both methods, nonunion (failure to heal, or unite) of the fracture can occur. Articular (cartilage) injury to the knee joint occurring during the trauma itself can lead to post-traumatic arthritis of the joint. Arthrofibrosis (stiffness) of the joint can occur if range of motion exercises are not instituted early enough after the injury. Infection can also occur post-operatively, particularly if surgery is done through compromised soft tissues. Deep venous thrombosis (blood clots in the leg and thigh veins) can occur secondary to the trauma or prolonged immobilization. Residual swelling of the limb can occur in the post-operative limb and is more commonly associated with high-energy fractures. Finally, unrecognized menisci or ligamentous injuries associated with the fracture can cause significant morbidity.
What is the principle of tibial plateau?
Initially, sports injury treatment using the P.R.I.C.E. principle – Protection, Rest, Icing, Compression, Elevation can be applied to a tibial plateau fracture. Nondisplaced fractures of the tibial plateau can often be treated non-operatively with a period of non-weight bearing with a hinged knee brace. Any period of limb immobilization should be kept brief as knee stiffness must be avoided. The knee is commonly locked in full extension for 1-2 weeks with the amount of flexion gradually increasing with time.
What does a fracture of the medial tibial plateau mean?
Fractures of the medial tibial plateau can sometimes signify a knee dislocation that has spontaneously reduced.
How long does it take for a knee to be locked in?
The knee is commonly locked in full extension for 1-2 weeks with the amount of flexion gradually increasing with time. The most important factors in determining the necessity of surgery are mechanical alignment of the limb as well as the articular congruity.
How to tell if you have compartment syndrome?
Later signs include decreased pulses, weakness and paresthesias (sensory changes).
What is the plateau of the tibia?
The tibial plateau is the flat top portion of your tibia bone, which runs from your knee to your ankle. The bottom end of your thigh bone (femur) and the top end of your tibia form your knee joint. The tibial plateau is a relatively flat surface of bone covered in cartilage. This is a very smooth, low-friction surface, designed to allow your knee joint to bend and straighten. There are two menisci, or shock absorbers made of cartilage, that sit between your tibia and the femur. These are commonly injured in sports activities.
What is plateau fracture?
A tibial plateau fracture is an injury in which you break your bone and injure the cartilage that covers the top end of your tibia (bottom part of your knee). The break can range from a single crack in your bone to shattering into many pieces. This fracture typically happens after a fall or a motor vehicle accident.
What is an external fixator?
An external fixator is a device made up of pins that are put in your femur (thigh bone) and tibia (leg bone) and bars that connect the pins together.
What is the knee shock absorber?
This is a very smooth, low-friction surface, designed to allow your knee joint to bend and straighten. There are two menisci, or shock absorbers made of cartilage, that sit between your tibia and the femur. These are commonly injured in sports activities. There is a large blood vessel that runs behind your knee.
How long does it take for a broken leg to heal?
This is to keep the bones from moving as you heal. Depending on your injury, this will last 6 to 12 weeks. You may need to use crutches, a walker and/or a wheelchair. A knee immobilizer or hinged knee brace may be used to provide support for your leg. You will be instructed to work on gentle motion of your knee, ankle, and hip. This is to prevent stiffness and also to help your cartilage to heal. Your surgeon will let you know how much you should bend your knee. You may be prescribed physical therapy to help with motion and strength. It is important to follow up with your surgeon to make sure your bones are healing well and that your motion is good.
Where to make cuts for knee surgery?
Once surgery is safe to do, your surgeon will make cuts in your leg to line your bones back up. Depending on how your bones are broken, these cuts may be on the front of your knee, the side of your knee, or both. There is rarely a need to make an incision on the back of the knee.
Where is the blood vessel in the knee?
There is a large blood vessel that runs behind your knee. The main nerves that supply your leg and foot are also found in the back of your knee, and two of them wrap around the outside of your knee. Figure 1: Skeleton model showing the knee joint. Figure 2: X-rays of the knee.
How to treat meniscal tear?
Your doctor will likely try nonsurgical options before resorting to surgery, including time, rest, anti-inflammatory medicines, ice packs and physical therapy. These treatments are often effective in relieving symptoms.
How to diagnose a torn meniscus?
To diagnose a torn meniscus, your doctor will physically examine your knee. This includes putting the knee through its range of motion, checking for tenderness or pain, and listening for a clicking or popping noise in the joint.
How long does it take to heal a torn meniscus?
Depending on the degree of the tear and surgery performed, recovery and rehabilitation can range from three or four weeks up to three months.
What kind of imaging is used to diagnose knee pain?
Further diagnostic tests can include X-rays, to rule out other possible sources of knee pain, and an MRI (magnetic resonance imaging), which can provide doctors a view of the meniscus and other soft tissues in the knee joint.
Can elderly people have knee pain?
In such cases, says Dr. Griesser, patients may have knee pain without recalling a specific event or injury that could have created the problem. "Mid dle-aged to elderly people often don't even know when it occurred. They just know the knee has started to hurt them over the course of several months.".