Tibial Plateau Fracture
What is it? A fracture of the tibial plateau that usually occurs with direct trauma to the knee, but can also be seen with axial compression of the knee from a fall and in the elderly from twisting type injuries.
How does it present? Patients usually present with significant swelling of the knee and inability to bear weight.
Common exam findings: Presence of effusion, difficulty with ambulation, tenderness over the proximal tibial and decreased range of motion can all be seen on exam. Evaluate closely for associated ligamentous and neurovascular injury.
Tests and treatment: Knee x-rays, including anteroposterior (AP), lateral and notch view should be obtained. Additional internal and external oblique views of the knee may be needed. Further evaluation of the fracture for articular involvement can be done with computed tomography (CT scan). Evaluation of the fracture and other suspected soft tissue injuries could also be evaluated with a magnetic resonance imaging (MRI). Treatment is most commonly managed by an orthopedic surgeon, but may be nonsurgical.