Tibial Plateau Fractures

Abstract

Tibial plateau fractures are periarticular fractures of the proximal tibia, often accompanied by soft tissue injury. Tibial plateau fractures constitute approximately 1% of all fractures and 8% of fractures in people over the age of 55. Tibial plateau fractures show bimodal distribution. The character of the fracture depends on the mechanism of injury. The tibial plateau is a portion of the proximal tibia that includes the articular surface. It is divided into the medial and lateral tibial plateau by the intercondylar eminence. There are various classifications of tibial plateau fracture. The Schatzker and treecolumn classifications are commonly used. A new way of thinking also informs us about the 3D morphology of the fracture, the mechanism of injury and which surgical approach to choose for the fracture. Radiological imaging is important in the evaluation of injury and in preoperative planning (x-ray, CT, MRI). Depending on the severity of the injury, treatment of the fracture ranges from conservative to surgical. Our goal in treatment is the preservation of soft tissue, reconstruction of the joint, reconstruction of the mechanical axis and early functional movement. The biomechanics of fixation, localization of the displaced joint fragment and soft tissue status must be considered when deciding on the surgical treatment approach. There are various complications due to being late and early stage. This chapter considers the definition, epidemiology, anatomy, diagnosis and treatment strategies of tibial plateau fractures.