Selected stable fractures
Nonsurgical Treatment
Minimally displaced fractures may be treated with a brace, protected weight bearing and close follow-up imaging while knee motion begins as directed.
Urgent orthopedic knee-fracture care
Tibial Plateau Fracture Treatment & Surgery in Atlanta
Prompt evaluation for fractures of the top of the shinbone that extend into the knee joint, including staged external fixation, ORIF and selected acute total knee replacement.
Tibial plateau fractures can permanently damage the knee joint.
High-energy injuries can also cause dangerous swelling and compartment syndrome. These fractures should be evaluated urgently by an orthopedic surgeon.
Urgent fracture evaluation
Joint-surface reconstruction
Staged external fixation
ORIF and knee replacement expertise
Understanding the injury
What Is a Tibial Plateau Fracture?
A tibial plateau fracture is a break at the top of the tibia where it forms the lower half of the knee joint.
Low-Energy and High-Energy Injuries
Older patients with weaker bone may sustain a tibial plateau fracture after a lower-energy fall. Younger patients more often sustain these injuries after a motor-vehicle collision, fall from height or other high-energy trauma.
The fracture may split the bone, push part of the joint surface downward or break the plateau into several pieces.
What the Surgeon Evaluates
- Joint-surface depression and displacement
- Overall knee alignment and stability
- Condition of the skin and soft tissues
- Meniscus and ligament injury
- Blood flow and nerve function
- Signs of compartment syndrome
!
High-Energy Fractures Can Cause Compartment Syndrome
Severe or rapidly increasing pain, pain with passive movement of the toes, a very tight swollen leg, numbness or weakness can indicate dangerous pressure building inside the leg. This is a surgical emergency and requires immediate emergency evaluation.
Treatment options
Treatment Depends on Displacement, Stability, Soft Tissues and Patient Age
These fractures range from small stable cracks to severe joint injuries requiring staged reconstruction.
Most displaced fractures
ORIF With Plates and Screws
Surgery restores the joint surface, corrects alignment and stabilizes the fracture with plates and screws. Bone graft or another filler may be used beneath a depressed joint surface.
Severe swelling or soft-tissue injury
Temporary External Fixation
A spanning external fixator may stabilize the knee while swelling improves and the skin becomes safer for definitive surgery.
Selected Older Patients May Be Candidates for Acute Total Knee Replacement
In an older patient with severe comminution, weak bone, preexisting arthritis or a fracture that cannot be reconstructed predictably, acute total knee replacement may be considered instead of traditional fixation.
This is not routine treatment for every older patient. In carefully selected cases, it may provide immediate joint stability and allow earlier weight bearing and mobilization than a prolonged period of restricted weight bearing after complex fracture fixation.
Long-term joint health
Tibial Plateau Fractures Can Lead to Post-Traumatic Arthritis
Even after technically successful treatment, the cartilage and supporting structures of the knee may have been permanently injured.
Why Arthritis Can Develop
- Damage to the cartilage at the time of injury
- Residual joint-surface irregularity
- Loss of normal knee alignment
- Meniscus or ligament injury
- Severe comminution or bone loss
The Goal Is to Preserve the Best Knee Possible
Fracture surgery cannot undo all of the original cartilage damage. The goal is to restore alignment, provide a stable joint surface and permit safe motion while minimizing the risk of future pain, stiffness and arthritis.
Some patients later require additional procedures, including total knee replacement, if post-traumatic arthritis becomes severe.
Recovery
Recovery Requires Protection, Motion and Careful Progression of Weight Bearing
Early phase
Control Swelling
Elevation, skin monitoring and protection of the soft tissues are early priorities.
As stability allows
Restore Knee Motion
Controlled motion helps reduce stiffness while the fracture or surgical fixation remains protected.
Later recovery
Advance Weight Bearing
Weight bearing progresses according to fracture healing, fixation strength and the treatment selected.
Local orthopedic knee-fracture care
Tibial Plateau Fracture Surgery Serving Atlanta and the East Metro Region
Atlanta Bone and Joint Specialists provides urgent orthopedic evaluation, staged fracture care, ORIF and selected knee replacement treatment for tibial plateau fractures.
Atlanta
Decatur
Snellville
Loganville
Fulton County
DeKalb County
Gwinnett County
Walton County
Tell our scheduling team that you have a confirmed or suspected tibial plateau fracture. Bring your imaging disc, CT scan, radiology reports and emergency-room paperwork.
Tibial plateau fracture FAQ
Frequently Asked Questions
Does every tibial plateau fracture require surgery?
No. Selected minimally displaced and stable fractures may be treated with bracing, restricted weight bearing and close follow-up. Displaced, depressed or unstable fractures are more likely to require surgery.
Why is surgery sometimes delayed?
Severe swelling and soft-tissue injury can make immediate surgery unsafe. A temporary external fixator may stabilize the knee until the skin and swelling improve.
Why can this fracture cause arthritis?
The fracture directly injures the knee cartilage and may also damage the meniscus, ligaments and alignment of the leg. These changes can lead to post-traumatic arthritis over time.
When is total knee replacement considered immediately?
Acute total knee replacement may be considered in selected older patients with severe comminution, poor bone quality, preexisting arthritis or a fracture unlikely to be reconstructed reliably.
Why is compartment syndrome important?
High-energy tibial plateau fractures can produce dangerous pressure inside the leg. Rapidly increasing pain, pain with toe movement, severe tightness, numbness or weakness require immediate emergency evaluation.
Have a Tibial Plateau Fracture? Get an Urgent Orthopedic Plan
Call Atlanta Bone and Joint Specialists for prompt evaluation of joint displacement, soft-tissue swelling, compartment-syndrome risk and the best option for fixation or selected knee replacement.
This page provides general educational information and does not replace an examination, imaging review or individualized medical advice. Seek emergency care for rapidly increasing pain, severe leg tightness, numbness, weakness, a cold or pale foot, an open wound or major trauma.