A tibial plateau fracture refers to a break or crack in the top of the shin bone at the knee. It involves the cartilage surface of the knee joint.

This joint helps support your body weight, and when it is fractured, it cannot absorb shock. If you experience a tibial plateau fracture, you may be prevented from putting weight onto your leg while you recover from injury.

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With tibial plateau fractures, there is a break at the top of the shin bone where the bone meets the knee joint, so there is often accompanying ligament and muscle tears, too.

Most tibial plateau fractures are a result of trauma to the leg, such as:

  • a fall from height
  • a motor vehicle accident
  • injuries from sports such as football or skiing.

Other risk factors include osteoporosis, infection, or mineral deficiency that weakens bones and makes them more susceptible to injury.

If you experience pain or discomfort in or around the upper part of your shin from impact, it may be a sign of a tibial plateau fracture. Other symptoms include:

  • difficulty bearing weight on your leg
  • bruising and swelling
  • paleness in leg as a result of decreased blood flow
  • pain in the joint with or without weight bearing
  • bone breaking through skin

Your doctor can provide a proper diagnosis by conducting imaging tests such as an X-ray or an MRI or CT scan.

One additional concern with a tibial plateau fracture is that swelling or bleeding in the anterior (front) compartment (muscle grouping) of the lower leg can cause increased pressure on the nerves, muscles, and blood vessels in that compartment.

Your doctor will likely test for the condition — called compartment syndrome. Acute compartment syndrome can lead to permanent muscle damage and is considered a surgical emergency.

Medical professionals provide six classifications for tibial plateau fractures to properly diagnose the injury and provide treatment options. Developed by Joseph Schatzker, MD, the system classifies the fractures into the following types:

  • Schatzker Type I: wedge-shaped pure cleavage fracture, with a depression or displacement of less than 4 millimeters
  • Schatzker Type II: a type I fracture combined with a depression in the bone
  • Schatzker Type III: depression in lateral tibial plateau — Schatzker IIIa is a lateral depression while Schatzker IIIb is a central depression
  • Schatzker Type IV: medial fracture of tibial plateau with a split or depression
  • Schatzker Type V: wedge fracture of lateral and medial tibial plateau
  • Schatzker Type VI: transverse fracture with a dissociation between the midsection of the bone and the narrow portion.

The degree of impact will likely indicate the severity of the fracture, as each successive type is more severe than the last.

Treatment plans for tibial plateau fractures depend on its classification. For more minor injuries, non-surgical treatment options include:

  • resting your knee
  • splinting your knee and not putting any weight on the injury so as not to damage the joint surface
  • taking pain medications
  • applying ice and keeping your extremity elevated while the bone heals.

If surgery is necessary, your surgeon will likely use screws and plates to realign the bone. A 2013 study showed surgical treatment of the fracture is generally effective in restoring knee function.

Recovery time varies depending on the severity of the injury and treatment method but usually lasts around three to six months.

A tibial plateau fracture occurs at the top of your shin and prevents you from being able to place weight on your leg.

If you experience trauma to your leg that results in pain, swelling, or a limited range of motion around your knee, consult with your doctor or go to an emergency room for proper diagnosis, treatment and recovery plan.