Tibial Plateau Fracture
Care for fractures at the top of the tibia with Dr. Steven Ward in Tucson and Oro Valley — restoring the knee’s joint surface and alignment when the break calls for surgery.
Call 520-881-1394Typical ranges for general education. Dr. Ward’s plan for you may differ.
What it treats
The tibial plateau is the top of the tibia, where it forms the lower half of the knee joint. The bone here is softer than the rest of the tibia. In a plateau fracture, the end of the femur is driven into it, which can split the joint surface or push part of it down.
- High-energy injuries such as falls from a height, sports injuries, and vehicle collisions, more common in younger people
- Low-energy falls in people with weaker bone, such as osteoporosis
- Related injuries to the meniscus, ligaments, skin, nerves, or blood vessels
- Symptoms include pain with weight on the leg, swelling, limited bending, deformity, and sometimes a pale or cool foot or numbness
Is surgery right for you?
Treatment depends on the fracture and on your health and activity level. Non-operative care may be used for stable breaks with little shift:
- A cast or hinged knee brace
- Limits on weight-bearing and motion
- Regular X-rays to make sure the bone stays in position
Surgery is usually recommended when the joint surface is pushed down or split apart, the knee is unstable or out of alignment, or the fracture is open. For active people, restoring the joint surface improves stability and motion and lowers the risk of arthritis. For some people with serious medical conditions, surgery may add more risk than benefit. A CT scan is typically used to plan treatment, and an MRI is sometimes ordered to check the meniscus and ligaments.
How the surgery is done
The surgery depends on the pattern of the break and on the condition of the skin and soft tissues:
- Plates and screws — through an incision, the fracture pieces are put back in place and held with a plate on the surface of the bone. Pushed-down joint surface is lifted back up, and the space left underneath is filled with bone graft or a bone substitute.
- Rod — some breaks just below the joint are held with a rod inside the bone
- Temporary external fixator — when swelling or skin damage makes early surgery unsafe, pins and an outside frame hold the leg until the soft tissues recover and final surgery can be done
- Emergency care — cleaning an open fracture to lower the infection risk, or releasing dangerous swelling in the calf (compartment syndrome)
Protecting the joint while it heals
Putting full weight on the leg too early can cause the joint surface to sink again. Follow the weight-bearing instructions exactly, even when the leg starts to feel better. Dr. Ward uses follow-up X-rays to decide when you can put more weight on the leg. If you smoke, quitting helps the bone heal.
Recovery overview
Typical ranges only. Healing depends on the fracture pattern, bone quality, and treatment, and Dr. Ward’s plan for you may differ.
Weeks 0–6
- No weight or limited weight on the leg, using crutches, a walker, or a wheelchair
- A knee brace may be used for support
- Knee motion begins as soon as the soft tissues and the fixation allow, sometimes with a continuous passive motion (CPM) machine
- Elevate the leg and check the incisions as instructed
Weeks 6–12
- Weight-bearing stays protected until X-rays show enough healing
- Physical therapy continues to build motion and thigh strength
- Follow-up X-rays at regular visits
Month 3 and beyond
- Full weight-bearing often takes about 3 months or more
- You may still need crutches or a walker at times as you rebuild strength and balance
- Long-term concerns include stiffness, instability, and arthritis, which Dr. Ward will review with you
When to call the clinic
Call 520-881-1394 if you notice any of the following after surgery or while you are recovering:
- A fever of 101°F or higher, or chills
- Redness spreading around an incision, or drainage that is cloudy, foul-smelling, or keeps soaking the dressing after the first few days
- New or worsening numbness, tingling, or weakness in the leg or foot once the anesthesia has worn off, or a foot that turns pale, blue, or cold
- Pain that is not controlled by your prescribed medication, ice, elevation, and rest
- Pain, swelling, or tenderness in the calf that is new or getting worse
- Severe pain that keeps getting worse, especially with a tight, swollen calf or numbness in the foot. Go to the ER, because this can be compartment syndrome.
It is normal for the knee to be swollen, bruised, and sore for a while, and for the leg to feel numb or weak until a nerve block or spinal anesthetic wears off. Use your crutches, walker, or brace as directed. Call if something feels different from what you were told to expect.
for chest pain, shortness of breath, or trouble breathing. These can be signs of a blood clot in the lungs and need emergency care.
If something does not match the instructions you were given, call the office. Dr. Ward or one of his physician assistants will get back to you.
Related resources
Knee post-op hub
Knee arthroscopy and knee replacement packets, rehab protocols, and anatomy guides.
Open pageKnee arthroscopy & meniscus resection
Dr. Ward’s knee arthroscopy page, including his meniscus resection rehab protocol.
Open pageExercise guides
Printable home exercise programs to use with your physical therapist.
Open pagePhysical therapy locations
Find a physical therapy clinic near you in Tucson and Oro Valley.
Open pageOrthoInfo: Proximal tibia fractures
Patient education on fractures of the upper tibia from the AAOS.
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