When a crash breaks the top of the shinbone inside the knee
An orthopedic trauma surgeon walks through a tibial plateau fracture
A crash can crack the top surface of your shinbone or push part of it down. Doctors call this surface the tibial plateau. It is where the shinbone meets the thighbone. The ligaments or meniscus in the knee may be hurt as well. [1]
This break runs into the joint. So how well the pieces line up affects walking and comfort later on. Some of these fractures heal in a brace. Others need surgery to rebuild the joint surface. [1]
Learn the shape of your fracture
Ask which part of the plateau broke. Find out whether the joint surface was pushed down or shifted out of place. Ask if a CT scan gave more detail or showed soft tissue injuries. [1]
If you had surgery, ask what was fixed. Find out whether a bone graft or a plate was used. Keep your scans and the surgery summary for future knee care. [1]
Stick to your weight bearing rule
Ask whether you can put no weight, some weight or full weight on the injured leg. Practice that rule with a therapist using crutches or a walker. Find out when knee bending and strength work should start. Feeling less pain, by itself, doesn’t show the joint surface is ready for more weight. Ask how your later X rays will help decide the next step. [1]
Speak up about new problems early
Call the surgical team about a fever or fluid leaking from the wound. Also call if numbness gets worse or you can no longer move your ankle or toes. Get urgent care for a cold or pale foot or leg pain that is severe and climbing. Chest pain and shortness of breath also need urgent care. [1]
Tell the team if knee swelling or a sense that the knee is unstable lasts after the bone heals. Arthritis can develop later on. Even so, any new symptom needs to be checked. [1]
Questions about your knee fracture
- How much of the joint surface was damaged?
- What are my exact rules for putting weight on the leg and bending the knee?
- When will scans and therapy change the plan?
Post your weight limit where you'll see it
Write your weight bearing limit on the front of your hospital discharge folder. Then show your therapist how you stick to it. [1]
Sources and further reading
These are general points from an orthopedic trauma surgeon’s perspective. How much weight you can safely bear and how far you can bend the knee depend on your fracture and repair. Follow your own written instructions.
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