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Fracture, Proximal Tibial Plateau, Sports Medicine

Holly J. Benjamin, MD, FAAP, FACSM and Spencer Kirk, MD, MS Reviewed 04/2019
 


BASICS

  • Tibial plateau fractures occur as a result of trauma:

    • Force directed either medially (valgus deformity) or laterally (varus deformity)

    • Axial compressive force

    • Combination of both

  • An axial compressi...

DIAGNOSIS

  • X-ray: anteroposterior (AP), lateral, oblique; possible tunnel view

  • Magnetic resonance imaging (MRI): indicated for assessment of associated ligamentous or cartilaginous injury

  • Computed tomogr...

TREATMENT

  • No more than 5 mm (0.5 cm) of depression/displacement is acceptable for conservative treatment.

  • Emergency department (ED) treatment:

    • Acute treatment:

      • Non–weight-bearing or toe-touch weight-bear...

ONGOING CARE

PROGNOSIS

  • High rate of osteoarthritis associated with tibial plateau fractures 7

  • Prognosis for full return of motion in the presence of osteoarthritis is poor.

  • Outcomes are generally better ...

REFERENCES

1
Gardner MJ, Yacoubian S, Geller D, et al. The incidence of soft tissue injury in operative tibial plateau fractures: a magnetic resonance imaging analysis of 103 patients. J Orthop Trauma....

ADDITIONAL READING

  • Elsoe R, Larsen P, Nielsen NP, et al. Population-based epidemiology of tibial plateau fractures. Orthopedics.  2015;38(9):e780–e786.

  • Prat-Fabregat S, Camacho-Carrasco P. Treatme...

CLINICAL PEARLS

  • Need to have a high index of suspicion with ligamentous injury, especially in the setting of large swelling shortly after injury

  • Although tibial plateau fractures have a low overall inc...

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