Non displaced Tibial Plateau Fracture

What is Non displaced Tibial Plateau Fracture

A tibial plateau fracture is a break in the top of the shin bone (tibia). The top of the tibia has a flat, smooth surface (tibial plateau). This part of the tibia is softer than the rest of the bone. It forms the bottom of the knee joint.

If a strong force shoves the thigh bone (femur) down and onto the tibial plateau, the tibial plateau can collapse or break apart at the edges. This may also be called an intra-articular fracture.

Tibial plateau fractures account for 1 percent of all fractures and are typically sustained with high-energy mechanisms.

Tibial plateau fractures may be associated with injury to nearby structures including vasculature, nerves, ligaments, menisci, and adjacent compartments.

While minimal tibial plateau fractures with no associated injuries can be safely managed non-operatively, typically this injury requires orthopedic consultation and operative management

A nondisplaced fracture means that the broken pieces of bone have not moved out of their normal position. This type of fracture can usually be treated without surgery.

In cases where there is a bone bruise or a nondisplaced fracture that does not cause significant pain, such as in high-level athletes, a rehabilitation program to allow the swelling to resolve followed quickly by a low-impact exercise program, including low resistance cycling and working in a pool, can help to maintain one’s cardiovascular endurance and allow for a quicker return to activities.

The tibia is the weight-bearing bone of the leg, located medially to the fibula.

The proximal part of the bone compromises the distal part of the knee joint. The tibial plateau has two articular surfaces, the medial and lateral tibial condyles, also called the medial and lateral plateaus.

The medial tibial condyle bears 60% of the knee’s weight and is a thicker structure. It is concave in shape and located slightly more distally compared to the lateral tibial condyle.

The lateral tibial condyle is convex in shape, thinner, weaker, and more proximal than the medial tibial condyle.

The intercondylar eminence is a bony structure between the two condyles that serves as an attachment point for the anterior cruciate ligament.

What are the causes?

Common causes of this type of fracture include:

• Car accidents.
• Jumps or falls from a significant height.
• Injuries from activities that put a lot of force on the knee, such as injuries from skiing, mountain biking, or contact sports.

What increases the risk?

You may be at higher risk for this type of fracture if:

• You play sports that put a lot of force on your knee, including contact sports.
• You have a history of bone infections.
• You are an older person with a condition that causes weak bones (osteoporosis).

What are the symptoms?

Symptoms of a nondisplaced tibial plateau fracture begin right after the injury. They may include:

• Pain that gets worse when putting weight on your knee or moving your knee.
• Knee swelling and bruising.

How is this treated?

This condition is treated by wearing a brace on your leg. You will not be able to put any of your body weight on the leg (weight-bearing restrictions). You may be given crutches, a scooter, a walker, or a wheelchair to help you move around. Treatment may also involve:

• Prescription pain medicine.
• Physical therapy.

Activity

• Do not use your leg to support your body weight until your health care provider says that you can. Follow weight-bearing restrictions.
• Use crutches, a cane, or a walker as directed.
• Ask your health care provider what activities are safe for you and what activities you need to avoid.
• Do physical therapy exercises as directed.
• Do not drive while wearing a brace on the leg that you use for driving.

Managing pain, stiffness, and swelling

• If directed, put ice on the injured area:
  • If you have a removable brace, remove it as told by your health care provider.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Move your toes and ankle often to avoid stiffness and to lessen swelling.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

General instructions

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or use heavy machinery while taking prescription pain medicine.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.

If you have a brace:

• Wear the brace as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the brace if your toes tingle, become numb, or turn cold and blue.
• Keep the brace clean.
• If the brace is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when you take a bath or a shower.

Contact a health care provider if:

• You have pain that does not get better with medicine.

Get help right away if:

• You have severe pain or swelling.
• You have new pain, swelling, or warmth in your lower leg.
• Your toes or foot:
  • Are unusually cold.
  • Turn a bluish color.
  • Are numb.
• You have chest pain.
• You have difficulty breathing.

Summary

• A tibial plateau fracture is a break in the top of the shin bone (tibia), which forms the bottom of the knee joint.
• A nondisplaced fracture means that the broken pieces of bone have not moved out of their normal position.
• Do not use your leg to support your body weight until your health care provider says that you can. Follow weight-bearing restrictions.
• Keep all follow-up visits as told by your health care provider. This is important.