Some tibial plateau fractures may require an external fixator prior to surgical reconstruction. A bone graft, either from the patient (autograft) or a donor (allograft), or a bone substitute may be needed if the bone fragments are lifted. A tibial fracture is surgically repaired using rods, plates, and screws. In the event of failed conservative therapy, bone displacement, or the tibial plateau fractured into multiple pieces, surgical intervention is necessary to correct and maintain bone alignment and restore function to the knee joint. A second injury, or lack of compliance with medical advice, can cause bone displacement and require surgery. Sequential x-rays and regular follow-ups are essential for monitoring bone alignment throughout the recovery period. Weight-bearing and movement will also be restricted during the early stages of recovery. The knee will be immobilized to ensure the bones remain aligned during the healing process. Conservative therapies may also be recommended for patients who are less active, have poor health overall, or experience chronic skin infections. If a tibial plateau fracture is suspected, immediate medical attention by a medical professional or orthopedic knee specialist is strongly advised.Ĭonservative therapies may be adequate to heal a confirmed tibial plateau fracture that is small and did not result in bone displacement. A significant amount of swelling can jeopardize the blood supply to the lower leg and foot requiring emergency surgery. What is the treatment for a tibial plateau fracture?Īlthough rare, tibial plateau fractures can result in significant inflammation of the surrounding soft tissues. Provencher, orthopedic knee specialist serving patients in Vail, Aspen, Colorado Springs, and the Denver, Colorado area, has the knowledge and understanding, as well as substantial experience in treating patients who have experienced a tibial plateau fracture. Individuals with osteoporosis, a mineral deficiency, or other underlying conditions are at a greater risk for tibial plateau fractures, even from a lower-impact injury such as a fall. Injuries to the tibial plateau can result in a single crack or the bone shattering into several fragments. A tibial plateau fracture is a condition in which this flat surface of the tibia becomes broken, often from a high-impact injury such as a motor vehicle collision. The flat shape provides a low-friction surface that enables the knee joint to bend and straighten. The tibial plateau is a relatively flat surface of bone at the proximal end of the tibia. The distal end of the femur and the proximal end of the tibia together form the knee joint. Begin partial weight bearing at 25% of body weight and increase by 25% approximately every 3 days.The larger and stronger of the two lower leg bones, the tibia (shin bone), is the second-largest bone in the human body behind the femur (thigh bone).Continue with Phase II exercises as indicated.Phase III – Strengthening and Proprioceptive Phase (Weeks 6 to 10): Weeks 6 to 8: Proprioception drill emphasizing neuromuscular control.Closed kinetic chain multi-plane hip strengthening on uninvolved side.Implement reintegration exercises emphasizing core stability.Begin stationary bike and pool exercise program (when incisions healed).Initiate global lower extremity stretching program.Continue with modalities to control inflammation.Maintain program as outlined in week 0 to 1.Phase II – Progressive Stretching and Early Strengthening (Weeks 1 to 6): Weeks 1 to 6: Multi-plane open kinetic chain straight leg raising.Quadriceps setting focusing on VMO restoration.Begin full passive/active knee range of motion exercises.Elevate the knee above the heart for the first 3 to 5 days. Use crutches non-weight bearing for 6 weeks.Ice and modalities to reduce pain and inflammation.Phase I – Maximum Protection (0 to 1 weeks): 0 to 1 week:
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