Tibial Plateau Fracture: Basic Anatomy, Treatment, and Complications

The tibial plateau is the flat top portion of your tibia bone, which runs from your knee to your ankle. There are two menisci made of cartilage that sit between your tibia and the femur.

There is a large blood vessel that runs behind your knee. The main nerves that supply your leg and foot are also found in the back of your knee, and two of them wrap around the outside of your knee.

A tibial plateau fracture is typically caused by a fall or a motor vehicle accident, where your thigh bone (femur) hits your tibia like a hammer hitting an anvil.

After breaking your tibial plateau, you will be unable to walk on your leg and may need to go to the emergency room. Depending on how bad the break is, you may need to wear a brace or a splint.

Depending on the severity of the break, tibial plateau fractures may be treated with or without surgery. Surgery involves realigning the bones and using plates, screws, and pins to hold them in place.

You will need to work on gentle motion of your knee, ankle, and hip after the initial treatment. Physical therapy may be prescribed to help with motion and strength. However, tibial plateau fractures can cause long-term complications like post-traumatic arthritis and permanent weakness.

Figure 1: Skeleton model of the knee joint and x-rays of the knee. (Source: Hutaif Orthopedic Center)

Figure 2: Examples of a patient with a tibial plateau fracture and subsequent swelling and bruising. (Source: Hutaif Orthopedic Center)

Figure 3: X-rays of a knee after tibial plateau fracture surgery, with plate and screws, and X-rays of post-traumatic arthritis after a tibial plateau fracture. (Source: Hutaif Orthopedic Center)