Why the tibial plateau is important
The tibial plateau is an important area because it is where the two menisci are seated and the two cruciate ligaments are tethered.
Fractures or bone breaks of the tibial plateau not only have the potential to upset the delicate mechanics of the knee, but they are also frequently missed by the emergency team despite the patient complaining of severe pain in the knee following an injury.
The issue is that one needs X-rays in two different planes to be able to see the often subtle outline of the fractured area. Also, the bone may not necessarily break off, but may be crushed and the fragment depressed, and it needs an experienced eye to appreciate this on X-ray.
Tibial plateau fractures can be difficult to manage and cause problems with rehabilitation. Key issues include:
- restoring the anatomy
- avoiding residual stiffness from arthrofibrosis
- avoiding residual pain from arthritis
Evaluation of the Results of Ilizarov Ring Fixation in Schatzker Type VI Tibial Plateau Fracture. Mostafa DG, Qavi M, Bari MM, Arifuzzaman M, Kamruzzaman M, Saha MK. Mymensingh Med J. 2018 Jan;27(1):136-143.
A systematic literature review of tibial plateau fractures: What classifications are used and how reliable and useful are they? Millar SC, Arnold JB, Thewlis D, Fraysse F, Solomon LB. Injury. 2018 Jan 27. pii: S0020-1383(18)30025-1. doi: 10.1016/j.injury.2018.01.025. [Epub ahead of print].
Outcome After Tibial Plateau Fracture: How Important Is Restoration of Articular Congruity? Singleton N, Sahakian V, Muir D. J Orthop Trauma. 2017 Mar;31(3):158-163.
Arthrofibrosis of the knee following a fracture of the tibial plateau. Haller JM, Holt DC, McFadden ML, Higgins TF, Kubiak EN. Bone Joint J. 2015 Jan;97-B(1):109-14.
Challenges with tibial plateau fracture
Embed Courtesy of: Saqib Rehman MD, The Philadelphia Trauma Symposium, USA and www.orthoclips.com