Fracture Care · Knee, leg & ankle
Tibial plateau fracture
Tibial Plateau Fracture (Shin Bone Fracture at the Knee) — Open Reduction and Internal Fixation (ORIF)
The condition
The tibial plateau is the flat top of the shin bone that forms the lower half of the knee joint. A fall, sports injury, or car crash can split or push down this joint surface. It causes pain, swelling, and trouble bearing weight; if it heals uneven, the knee can become unstable and arthritic.
The surgery
Through one or two incisions around the knee, the joint surface is lifted back into place and held with plates and/or screws; bone graft or bone substitute may fill gaps beneath it. A torn meniscus may also be repaired. If swelling is severe, surgery may wait until it settles. The final plan is determined during surgery.
Recovery at a glance
- Weight-bearing
- Touch-down weight (foot flat, ~20 lb) with crutches for 6 weeks; some stable fractures allow earlier full weight bearing. After the 6-week x-rays, weight builds to full over 2 weeks.
- Motion
- Knee bending to 90° for 4 weeks, then as tolerated; full straightening is the top priority. No motion machine. Bike and pool from 6 weeks.
- Daily life
- Desk work often within 2–3 weeks. No driving while taking narcotic pain medication.
- Running
- Running and hopping typically between 4 and 6 months, once healed and strength reaches 80% of the other side.
- Sports
- Full release typically 5–6 months, after strength testing.
A general guide. Your restrictions and timeline may change based on what is found and done at surgery.
Risks & benefits
Benefits: Restoring a smooth, level joint surface gives the best chance of a stable, well-functioning knee. Risks are uncommon and include infection, blood clots, knee stiffness, the joint surface settling or healing out of line, wound-healing problems, hardware irritation that may require removal, knee arthritis over time, injury to nearby structures (such as nerves, blood vessels, or cartilage), stiffness, persistent pain, dangerous swelling of the leg muscles (compartment syndrome; rare), and the need for further surgery. These will be reviewed with you in detail before surgery.
Patient Surgical Information
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Before & after every surgery