Tibial plateau fracture

The tibial plateau is the flat top of your shin bone — the platform the end of your thigh bone rests on inside your knee joint. It's what carries your body weight every step. Fractures here happen when a hard load drives the knee straight down combined with a sideways force — classically a pedestrian getting hit by a car bumper (the so-called bumper fracture), a fall from a height, or a hard sports collision. Surgeons grade these I through VI on the Schatzker classification, ranging from a clean split on one side to a crush of both sides of the platform.

Tibial plateau fractures rarely happen alone — torn menisci, torn ligaments, and dangerous swelling in the leg muscles (compartment syndrome) often come along with them and need a systematic look.

Knee swelling from blood inside the joint, the inability to put any weight on the leg, and tenderness right over the upper shin bone. A CT scan with 3D reconstructions is mandatory before surgery. An MRI checks the menisci and ligaments inside the joint. We also carefully check pulses and blood flow in the leg — the artery that runs behind the knee can be torn by these fractures and that's a limb-threatening emergency.

Surgery is needed when the joint surface has sunk down significantly, when the joint platform has spread wider than it should, when ligaments are also torn and the knee is unstable, when the skin is torn open over the fracture (an open fracture), or when an infection in the bone develops. The repair uses plates and screws to put the joint surface back together, often with bone graft to fill in crushed areas.

External patient-education references and related OSI pages for additional background:

• Britannica — Bone disease (fractures)
• Britannica — Knee (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language