How to Diagnose and Treat a Tibial Plateau Fracture

Опубликовал Admin

26-08-2021, 05:20

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A tibial plateau fracture is a break in your tibia, or shin bone, that extends into the knee. In some cases, this can be a minor fracture that heals quickly with only a knee brace or cast. In other cases, the bone can shatter, break through the skin, or cause damage to the soft tissue around your knee. Either way, if you think you have a tibial plateau fracture, you should go to the emergency room right away to make sure there is no permanent damage from your injury.

Diagnosing a Tibial Plateau Fracture

Go to the emergency room if you think you have a tibial plateau fracture. A tibial plateau fracture can lead to serious complications, such as permanent skin or muscle damage or arthritis. If you suspect you may have a tibial plateau fracture, go to the emergency room right away to confirm.
- Tibial plateau fracture occurs most often in car crashes, sports injuries, and, in the elderly, falls.
- Avoid putting weight on the injured leg until you rule out a fracture since it could cause a lot of pain or cause you to lose your balance.
Splint your knee to keep it as still as possible. To avoid making the injury worse, keep your leg as still as possible while you are getting to the emergency room. You can use a rolled-up newspaper or towel, a heavy stick, a wooden board, or anything rigid to hold your leg in place, and tape, a shoelace, a rope, or a belt to hold the splint in place.
- Use padding like a piece of cloth or gauze if there is bleeding or if it is too painful to place the splint against the injury.
- Keep your leg fully extended and don’t put any weight on it until you know the extent of your injuries.
Examine the placement of the injury visually. A tibial plateau fracture is a break in the tibia, which is your shin bone. The break continues to the knee. Look for a sunken area around the knee, as well as broken skin, or "tenting" where the bone tries to break through the skin.
- If bone is breaking through the skin, you may need urgent surgery.
Look for swelling or a limited range of motion on the injured leg. A tibial plateau fracture can cause the area around the knee to swell up. You also won't be able to fully bend your knee or put your weight on the injured leg.
Try to move your big toe to check for compartment syndrome. Compartment syndrome decreases blood flow to your muscles to a dangerous extent and can cause permanent damage. If you have severe pain when you move your big toe, you can't feel your foot, or you have severe pain in your foot, you need surgery immediately. A doctor will perform these tests to determine what course of action to take next.
- It can be hard to concentrate on where the pain is coming from, but it's important for your doctor to know if you need surgery urgently.
Use an x-ray to confirm a tibial plateau fracture. A doctor will use an x-ray to determine the location of your fracture as well as how big it is. The x-ray will help the doctor come up with a plan to treat your tibial plateau fracture, including if you will need surgery.
- If your fracture is small, you may also need an MRI to confirm the injury.

Treating a Tibial Plateau Fracture

Wear a knee immobilizer, cast, or hinged knee brace for small breaks. If you have a small fracture, such as a fracture from a fall, splint the knee so it’s fully extended and don’t put any weight on it. You may just need to wear a cast or brace to keep your knee still while it heals. You will need several follow-up appointments to check that your fracture is healing properly and you may need physical therapy.
- A small tibial plateau fracture will take 3-4 months to heal completely. Be sure to follow your doctor's treatment recommendations until you are completely healed.
Be prepared for surgery if your bone is displaced, through the skin, or unstable. For larger or more complicated fractures, you may need surgery to realign the bone and make sure none of your soft tissue is permanently damaged. Depending on how complicated your injury is, surgery might take 1-2 hours, and you will most likely stay overnight in the hospital.
- Surgery might include a bone graft or bone cement, as well as muscle and tendon repair.
- Look for orthopedic consultation within 48 hours even if your fractures are displaced only by a few millimeters or you have meniscal or ligamentous injuries.
- In severe cases, you may need metal pins inserted into the bones to stabilize them. This can be performed within 1-2 weeks after the injury.
Take over-the-counter pain medication to relieve pain at home. If you are experiencing pain after you go home, take acetaminophen, ibuprofen, or a combination of both. Follow instructions that come with the medication to make sure you take the correct dosage.
- If you are still experiencing a lot of pain, even with medication, ask your doctor about the possibility of prescribing stronger medication.
Ice your leg to reduce swelling and pain. Ice your leg for up to 20 minutes at a time. Do not ice your leg while you are sleeping.
- Be sure to keep your dressing dry. Place a towel between your leg and the ice if there is condensation.
Elevate your leg if it is swollen. If your knee starts to swell after you go home, elevate your leg so that your toes are above your nose. Keeping your knee above your heart reduces swelling. Keep your knee elevated as often as you can for 2 weeks after the injury.
- Combine elevation with icing for pain relief.
Keep weight off of your leg for about 6 weeks. You may need to use crutches or a wheelchair to get around while you are recovering from your fracture. Your doctor will tell you when you can put any weight on your leg or if you will need to keep weight off of it entirely. The length of time you need to keep weight off your leg depends on the severity of the fracture and how fast you heal.
- You’ll usually need to wear a brace for 8–12 weeks to completely heal.
- With a minor fracture, you can walk or bend your knee if you can tolerate it, but don't go on long walks or stand too much.
- For a severe fracture, you may need to keep weight off of your leg for even longer.
Attend physical therapy 6 weeks after your injury. After 6 weeks, most patients have recovered enough to return to walking. After keeping your weight off of one leg for 6 weeks, you will need some physical therapy to help you start moving normally again.
- With some minor fractures, you may not need physical therapy.
- In more serious cases, you may need 12 weeks to recover before going back to walking.
Return to your normal activities after 4 or more months of healing. In most cases, a tibial plateau fracture will heal after 4 months, and you can go back to your normal exercises and activities. However, in some more complicated injuries, a tibial plateau fracture can take a year or more to heal. Follow the recommendations of your doctor and physical therapist to keep active while your recovery moves forward.
- If you go back to aggressive physical activity too soon after injuring yourself, you can re-injure and take even longer to recover.