Types of Tibial Plateau Fractures
There are different classification systems that are widely accepted. In each of these systems, there are 6 types of fractures based on the fracture pattern and fragment anatomy. They are:
- I. Wedge Fracture – high energy fracture seen mostly in younger patients, the wedge is not depressed (below the normal level)
- II. Split Compression – very common in elderly with osteoporosis, the wedge is displaced and may be depressed
- III. Local Compression Fracture of the Lateral Plateau – depression in the articular (part of the bone that comes into contact with other bone) surface
- IV. Medial Plateau Fracture – high velocity fracture with bone fragmentation, in some cases not able to be reconstructed
- V. Bicondylar Fracture – wedge fractures of medial and lateral plateau, in half of these cases there will be peripheral meniscal detachment
- VI. Complex Bicondylar Fracture – high energy trauma with combination of forces, tibial plateau break with separation from the long bone (tibia), 1/3 are open fractures and nearly 90% include extensive soft tissue damage
Complications with Tibial Plateau Fractures
With some tibial plateau fractures, there can be injury to the ligaments, peroneal nerve, menisci, or the popliteal artery. Other complications are loss of range of motion, osteoarthritis, bone fragments, and edema (accumulation of fluid).
Recovery from Tibial Plateau Fractures
Not all tibial plateau fractures require surgery. Some fractures can be treated non-operatively. In either case, you will not be able to put weight on the broken leg for 6-12 weeks. During that time you will need to pursue therapy to maintain some muscle strength and to work on ROM. The degree of ROM you will be able to attain is dependent on the type of break, complications, and your commitment to physical therapy.
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