Fracture of the lateral tibial plateau: what does this mean?


Q: Mildly depressed acute fracture of the lateral tibial plateau ? What exactly does this mean ?


A:   The tibial plateau is one of the most critical load-bearing areas in the human body; fractures of the plateau affect knee alignment, stability, and motion. Early detection and appropriate treatment of these fractures are critical in minimizing patient disability and reducing the risk of documented complications, particularly posttraumatic arthritis. All high-energy fractures need to be immediately checked for soft-tissue integrity and impending compartment syndrome. The overall management can be one of the following: Joint aspiration, rest, immobilization, compression, elevation, and other antiedema measures, traction can be used as a temporary or definitive management modality. Open fractures need to be addressed by surgical debridement of open traumatic wounds within 8 hours of injury. Closed fractures undergo external fixator placement based on patient stability and operating room availability. Not all fractures of the tibial plateau require surgery; some may be treated with cast and traction if they are non-displaced and stable. The follow-up with imaging studies is done every 2 weeks for 6 weeks; with activity restriction for 4-6 months. Open or arthroscopic-assisted techniques are considered for fractures with displacement.

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