Features

Tibial plateau fractures are most common in adults between 50 and 60 years of age, but may occur in adults of any age.

Presentation is with a badly swollen, often deformed knee which is markedly bruised.

On examination, tenderness is felt at the site of the fracture but may also be noted on a non-fractured site, due to ligamentous injury. Haemarthrosis and pain may make it difficult to test movements around the knee.

Several different views may be required in order to fully map out the injury. Not uncommonly, CT may be necessary to accurately assess the degree of comminution or depression.

The injury may be:

• a simple fracture of either the lateral, or the medial, condyle - more commonly in younger patients
• a comminuted fracture of the lateral condyle in which the fragments have been crushed into the tibia to produce a depressed plateau - more commonly in older patients
• a fracture to both condyles with the tibial shaft wedged in between
• a combined condylar and subcondylar tibial fracture - associated with severe axial force