Tibial Plateau Fractures — Treatment and Recovery

What Is the Tibial Plateau?

The flat upper surface of the tibia (shinbone) on which the femur (thighbone) rests. Tibial plateau fractures are intra-articular fractures—they affect the joint surface, which makes them more complex.

How Do They Occur?

• Road traffic accidents
• Falls from a height
• Sports injuries (skiing)
• Minor trauma in elderly individuals with osteoporosis

Classification (Schatzker)

Type I—A simple split of the lateral plateau, common in young people.

Type II—A split combined with depression of the lateral plateau. The most common type.

Type III—Pure depression, more common in the elderly.

Type IV—A fracture of the medial plateau. More severe.

Type V—A bicondylar fracture. Often unstable.

Type VI—With metaphyseal-diaphyseal dissociation. The most severe type.

Treatment

Non-surgical—for stable, non-displaced fractures: immobilization in a brace, non-weight-bearing for 6-8 weeks, followed by physical therapy.

Surgical—for displaced, unstable fractures, or significant depression: anatomical restoration of the joint surface, fixed with plates and screws. This is planned using a CT scan.

Recovery

• First 6-8 weeks: Non-weight-bearing walking, mobility exercises
• Months 2-3: Progressive weight-bearing, intensive physical therapy
• Months 3-6: Gradual return to activities
• 6-12 months: Full recovery

The Risk of Post-Traumatic Osteoarthritis

Even with the best treatment, a tibial plateau fracture increases the long-term risk of osteoarthritis. Long-term follow-up is essential.

→ Knee Osteoarthritis

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