Tibial plateau fracture fixation is an operation to repair a break in the top of the shinbone where it forms the knee joint. These fractures involve the joint surface and require precise reconstruction to preserve knee function.
An incision is made on the side of the knee over the fracture. The depressed or displaced joint surface is elevated back to its normal position, often with bone graft to fill any voids. The fracture is then held in place with plates and screws. Arthroscopy (keyhole camera) may be used to check the joint surface alignment. The operation takes one and a half to three hours depending on complexity.
Surgery is recommended when the tibial plateau fracture is displaced, depressed, or unstable. These fractures involve the weight-bearing surface of the knee, and precise alignment is essential to prevent early arthritis and instability.
Undisplaced or minimally displaced fractures may be treated with a hinged knee brace, restricted weight-bearing, and physiotherapy. Close monitoring with repeat X-rays is needed to ensure the fracture does not displace.
CT scanning is essential for surgical planning. Surgery may be delayed for several days to allow swelling to settle — operating through very swollen tissue increases the risk of wound problems.
Accurate restoration of the joint surface gives the best chance of a good functional outcome and delays the onset of post-traumatic arthritis. Most patients achieve a functional range of knee movement.
Very common after tibial plateau fractures. Early physiotherapy is essential.
Expected for several months.
Arthritis may develop over time regardless of treatment, depending on the severity of cartilage damage.
The skin around the proximal tibia is vulnerable, particularly if surgery is performed through swollen tissues.
Deep infection around metalwork. Risk increases with open fractures.
A surgical emergency requiring fasciotomy. Uncommon but must be watched for.
The fracture may fail to heal or heal in a suboptimal position.
Associated injuries within the knee may need treatment at the same time or later.
DVT despite preventive measures.
General or spinal anaesthesia. The patient is positioned supine.
Weight-bearing is typically restricted for six to twelve weeks to protect the joint surface while it heals. A hinged knee brace may be used. Physiotherapy begins immediately to maintain knee movement. Range of motion exercises are critical. Full recovery takes six to twelve months. Some patients eventually require knee replacement if significant arthritis develops.
Regular X-rays at two weeks, six weeks, three months, and six months. Physiotherapy is critical.
There is an increased risk of post-traumatic arthritis after tibial plateau fractures, even with excellent surgical reconstruction. The risk depends on the severity of the original cartilage damage.
Usually six to twelve weeks, depending on the fracture pattern and healing. Your surgeon will guide this.
Some patients develop significant arthritis years later and may eventually benefit from knee replacement, but many do well long-term.