The bones are extremely resilient, and even pliable to some extent, based on their most remarkable structure. This is ensured by the stored organic and inorganic substances and the beam-like nature of the bones. However, these advantages do not always protect against a tibial plateau fracture or a broken tibia.
What is a tibial plateau fracture?
The medical term tibial plateau fracture is made up of several parts of the word. The tibia is the shin bone, which is located at the front of the lower leg. A fracture here refers to a broken bone. For hs dictionary definitions, please visit foodanddrinkjournal.com.
The head of the tibia is a special anatomical area of the tibia that is thickened and represents the transition to the joint. The head of the tibia is also referred to as the caput tibiae in the exact medical terminology.
A tibia fracture is therefore usually an injury. The tibial plateau fracture is a fairly common trauma that requires intensive treatment and can sometimes cause consequential damage and complications.
Causes
The causes of a tibial plateau fracture are usually the effects of mechanical forces, which primarily occur suddenly and unexpectedly. These are mainly falls and hitting the legs from a great height on an unyielding surface.
A tibial plateau fracture can also be caused by internal triggers. These refer to previous damage to the bone structure through the infiltration of a tumor into the associated weakening of the bone substance and to existing osteoporosis. The bone loses its stability and a tibial plateau fracture can result.
If it is caused by permanent overload, a tibia head fracture cannot be ruled out either. Tibial plateau fractures mainly occur as a result of sports injuries or accidents, or they also occur during unsecured activities in private households.
Symptoms, Ailments & Signs
In a tibial plateau fracture, the tibial plateau is broken. Accordingly, complaints mainly occur in the knee and lower leg area. Externally there is a swelling. Patients complain of severe pain that occurs when touched.
Bruising also occurs regularly. A tibial plateau fracture inevitably leads to restricted movement. Those affected can only walk with pain and must be supported. Just getting up from a sitting or lying position causes problems. Patients are sometimes dependent on help with everyday tasks such as going to the toilet or getting up in the morning.
Only after a few weeks of healing can the joint be used again without discomfort. The fracture of the tibial plateau rarely occurs alone. The cruciate and collateral ligaments are usually also injured as a result of the accident. Even the meniscus, which acts as a shock absorber in the knee joint, can be damaged. It is therefore important that the healing is accompanied by experts.
Therapists are regularly involved. If the tibial plateau fracture is not completely cured, permanent sensory disturbances will also occur. Patients sometimes report paralysis or sensitivity to the weather. Osteoarthritis can set in. If sufferers adopt a relieving posture and put excessive strain on the other tibial plateau, this can result in permanent physical malpositions.
Diagnosis & History
Since a tibial plateau fracture can occur in different areas of the lower leg, varying symptoms are also perceived. However, the tibial plateau fracture is the same in all areas of the shinbone that enormous painful discomfort occurs.
Those affected also notice a tibial plateau fracture through swelling of the tibia. Standing up independently after a tibial plateau fracture is not feasible. In addition, after a tibial plateau fracture, the tibia lost all of its resilience. The lower leg has an abnormal shape. Bruises and twists as well as shape deviations are indicative of a tibia fracture.
The diagnostics and differential diagnostics for a tibial plateau fracture include a palpation and a movement test by the doctor. Computed tomography or magnetic resonance imaging and an X-ray are also popular. Doppler sonography is also used if a tibia head fracture is suspected.
Complications
Various complications can arise from a fracture of the tibial plateau. The fracture is often associated with impairments of the cruciate ligament, inner ligament or outer ligament in the knee. The meniscus is also often affected, which is caused by splintered bone parts. Even years after the injury, there is a risk of arthrosis of the knee joint.
In order to counteract this unpleasant after-effect, surgical treatment is usually carried out. Possible complications of a tibial plateau fracture also include injuries to the arteria politea, the artery in the hollow of the knee, which is usually the case with a comminuted fracture. Nerve involvement, on the other hand, is rare.
However, damage to the fibular nerve is possible if there is an accompanying fracture of the fibular head. A comminuted fracture or an impression fracture (indentation fracture) is also often responsible for knee osteoarthritis. Osteoarthritis occurs due to inaccurate joint surface reduction.
Compartment syndrome is also one of the conceivable effects of a tibial plateau fracture. The muscles swell as a result of the injury. Within the lower leg, the muscles are stored in several compartments or fascia. When swelling occurs within these closed areas, the muscles no longer have room to expand. This cuts off the blood supply.
Because the tissue is only insufficiently supplied with blood, it threatens to die. After surgical treatment of the tibial plateau fracture, wound healing disorders can occur. This risk is particularly high if the procedure is carried out too early. In addition, an infection is possible, which makes it difficult for the fracture to heal.
When should you go to the doctor?
If severe pain in the limbs occurs after a fall, an accident or physical trauma, a doctor should be consulted. If the symptoms persist or increase in intensity, the person concerned needs a comprehensive examination for a diagnosis. Restrictions in mobility, a decrease in physical resilience and discoloration of the skin must be presented to a doctor. If bruises develop or if there are visual changes in the lower leg or knee, these are causes for concern.
If the knee joint cannot be bent as usual, if there are changes in the movement sequences or if the person concerned needs help to move, a doctor should be consulted. Sensitivity disorders, tingling on the skin or irregularities in blood flow should also be examined. These are signs of a health condition that requires treatment.
If everyday obligations can no longer be fulfilled independently, if gait is unsteady or if there are behavioral problems, it is advisable to consult a doctor. Paralysis, sensitivity to the weather, a protective posture of the body or impairments of the muscular system must be presented to a doctor. Without medical care, there is a risk of consequential damage or irreparable damage to the skeletal system. If the person concerned cannot do the usual sporting activities because of their symptoms, they should consult a doctor.
Treatment & Therapy
Treatment of a tibial plateau fracture includes conservative therapy without surgery or surgical repair of the fracture. In the first variant of the treatment of a tibial plateau fracture, the fracture areas are moved back into their natural position (repositioning) and stabilized with a plaster cast, an external fixator or a fixed splint.
In order to avoid muscle atrophy due to prolonged immobilization, physiotherapy can be carried out after a certain period of time.
If the tibial plateau fracture shows a complicated picture, an operative method is used. This includes the insertion of an intramedullary nail and the insertion of special retaining plates. The cross bolts or locking systems have also proven their worth in surgical treatment. These are selected when the fractures are so-called comminuted and torsional fractures or when the fracture is in the immediate vicinity of the joint.
Different components are also selected for cleft and compression fractures. These stabilizations are compatible with the body and can remain on the bone for a longer period of time. Surgical treatment of a tibial plateau fracture does not always require general anesthesia.
Prevention
In order to avoid a tibial plateau fracture and its consequences, it makes sense to recognize excessive strain on the lower extremities in good time in order to eliminate the risk of a stress fracture. In all practical activities at great heights, sufficient safety should always be ensured in order to avoid fractures in the event of a fall. Since tibial plateau fractures often occur during sports, the muscles must be warmed up accordingly in order to reduce the risk of fracture.
Aftercare
Follow-up care is required for both conservative and surgical treatment of the tibial plateau fracture. It consists primarily of physiotherapeutic measures. These help the patient to regain his usual ability to move after the tibial plateau has been immobilized for a long period of time. It usually takes two to three months before the physiotherapy exercises can begin.
In the course of the aftercare, the loads are increased step by step. In this way, overstraining the tibia head can be avoided. The aftercare of a tibial plateau fracture requires a lot of patience from the patient. The fracture has roughly healed again after around eight to twelve weeks. It can take up to a further six weeks for the affected person to be able to move again.
However, the patient can speed up the healing process. To do this, he should only put as little stress on his knee as possible. In an emergency, assistants can also be used, but this should be done rarely due to the pressure loads.
After surgical treatment of the tibial plateau fracture, the patient receives painkillers. Pain therapy is considered to be extremely important, as otherwise there is a risk of chronic pain symptoms. During an operation, the removal of the inserted screws or plates can also be part of the aftercare. Surgical removal depends on the age of the patient and whether the metal parts cause discomfort.
You can do that yourself
A tibial plateau fracture requires immediate medical attention. Self-help measures are not indicated for broken bones immediately after the break. If there is no medical treatment or if therapy starts too late, the risk of permanent damage and severe mobility restrictions that can last a lifetime increases.
Patients with a tibial plateau fracture support the medical treatment by following the doctors’ instructions regarding physical rest and avoiding certain movements or even sport. In addition, people with a tibial plateau fracture attend all check-up appointments with the doctor. While the bandage is on the leg, the patients particularly refrain from physical exertion. After the doctor has removed the bandage, the patients can use scar care to promote the healing of the scar and achieve the most aesthetic result possible.
Those affected refrain from vigorous physical activity for as long as the doctor treating them prescribes it. After that, the leg must gradually be accustomed to physical exertion again. Patients with a tibial plateau fracture usually visit physiotherapy and learn suitable training exercises. Those affected also carry out these in their own four walls. Shoe inserts can also be prescribed after the fracture to support the skeleton and muscles and prevent poor posture.
