Tibial plateau fracture

Tibial plateau fracture
Classification and external resources
A severe tibial plateau fracture
ICD-10	S82.1
AO	41-B1 - 41-C3
MeSH	68013978

A tibial plateau fracture is a bone fracture or break in the continuity of the bone occurring in the proximal part of the tibia or shinbone called the tibial plateau; affecting the knee joint, stability and motion. The tibial plateau is a critical weight-bearing area located on the upper extremity of the tibia and is composed of two slightly concave condyles (medial condyle and lateral condyle) separated by an intercondylar eminence and the sloping areas in front and behind it. It can be divided into three areas: the medial tibial plateau (the part of the tibial plateau that is nearer to the center of the body and contains medial condyle), the lateral plateau (the part of the tibial plateau that is farthest away from the center of the body and contains the lateral condyle) and the central tibial plateau (located between the medial and lateral pleateaus and contains intercondylar eminence). Depending on the injury pattern, lesions may be restricted to the tibia or may have significant soft tissue injury as well as meniscal and ligamentous injuries to the knee. However, a standard tibial plateau fracture involves either cortical interruption, depression or displacement of the articular surfaces of the proximal tibia without significant injury to the capsule or ligaments of the knee.

Tibial plateau fractures typically presents with knee effusion, swelling of the knee soft tissues and inability to bear weight. The knee may be deformed due to displacement and/or fragmentation of the tibia which leads to loss of its normal structural appearance. Blood in the soft tissues and knee joint (hemarthrosis) may lead to bruising and a doughy feel of the knee joint. Due to the tibial plateau's proximity to important vascular (i.e. arteries, veins) and neurological (i.e. nerves such as peroneal and tibial) structures, injuries to these may occur upon fracture. A careful examination of the neurovascular systems is imperative. A serious complication of tibial plateau fractures is compartment syndrome in which swelling causes compression of the nerves and blood vessels inside the leg and may ultimately lead to necrosis or cell death of the leg tissues.