Description of Tibial Plateau Fractures
Fractures which involve the tibial plateaus range from very small fractures, which are only seen on MRI scans, to those which involve a significant injury, which results in a Humpty-Dumpty appearance of several bone pieces which can be almost impossible to put back together. While those with fractures which only show up on MRI scan have an excellent outcome and a fairly quick return to activities, those involving significant disruption with multiple pieces of the lateral tibial plateau often have a poor prognosis.
Symptoms of a Tibial Plateau Fracture
- Pain when weight is applied
- Limited range of motion
- Severe cases – numbness or “pins and needles” in the foot due to nerve damage
The tibial plateau is made of cancellous bone, which is softer than the thicker bone lower in the tibia. Tibial plateau fractures are caused by a force driving the lower end of the femur (thigh bone) into the soft bone of the tibial plateau. The impact often causes the cancellous bone to compress and remain sunken. This damage to the tibial plateau may result in improper limb alignment, and over time can lead to arthritis, instability, and loss of motion in the knee.
It is not uncommon in athletic activity, such as with skiers, basketball players, football players, and court type sports to sustain a “bruise” of the bone. In these circumstances, the bone sustains enough of a load such that there is some swelling of the bone, but that an actual fracture does not occur. In some of these instances, such as with an ACL tear, there can be a disruption of the bone with a small fracture which only shows up on an MRI scan. These types of fractures have a very good prognosis and a period of time to allow the bone bruise and fracture to heal is required.