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A fracture, or break, in the upper part of the shinbone (the tibia) may be the result of a low-impact injury, such as a fall, or from a high-impact injury, such as a motor vehicle accident. Proper identification and management of these injuries will help to restore limb function (such as strength, motion, and stability) and reduce the overall risk of arthritis.
Physicians describe the bone comprising the tibial plateau as cancellous (or crunchy), as opposed to the thicker cortical bone of the tibial shaft. Cancellous bone may compress and remain depressed when injured.
Whether treated with surgery or without, Doctors must treat both the bony injury (the fracture) and any soft-tissue injuries together.
Fractures that involve the upper fourth of the lower leg, or tibia, may or may not involve the knee joint. Fractures that enter the knee joint may render the joint imperfect and the joint surface irregular. Additionally, these fractures may result in improper limb alignment. Either of these factors may contribute to excessive joint wear, which can cause arthritis, instability, and loss of motion.
The force and direction of the injury determines the pattern of a fracture. A fractures "pattern" refers to the fractures location and displacement in the knee.
symptoms of a tibial plateau fracture include:
Pain When Bearing Weight.
Tenseness and Swelling Around the Knee; Resulting in the Limitation of Leg Bending.
Deformity Around the Knee.
Pale, Cool Foot.
Numbness Around the Foot. Numbness, or “the feeling of pins and needles,” within the region of the foot raises concern about whether nerve injury or excessive swelling within the leg has occurred.
If these symptoms present after a fracture, you should have an assessment done in the emergency room as soon as possible.
In rare instances, soft-tissue swelling may be so severe that it threatens the blood supply to the leg and foot (a condition referred to as compartment syndrome). This may require emergency surgery in which vertical incisions are made to release the skin and muscle coverings, also known as a fasciotomy. Doctors often leave these incisions open and as they close naturally days or weeks later as the soft tissues recover and swelling resolves.
If the condition of the soft tissues does not allow the application of a cast or splint, Surgeons may consider an “external fixator”. With this device (often temporary), Surgeons insert pins above and below the joint. These pins exit the skin and connect to bars, which stabilize the knee joint.
Nonsurgical treatment may include restrictions on motion and weight bearing, in addition to the application of external devices such as braces or casts. Typically, Doctors assess the soft tissues, and take X-rays at prescribed intervals. Knee motion and weight bearing begin as the injury and method of treatment allow.
If patients elect to undergo surgery, they may consider several devices. In some cases with a broken upper tibia but an intact joint, surgeons may use a rod or plate to stabilize the fracture.