Understanding your injury

The tibial plateau is the upper surface of the shinbone at the knee. A fracture can split or depress this surface and may injure surrounding ligaments, the meniscus or soft tissues. Examination assesses swelling, wounds, knee alignment, circulation and nerves. X-rays and CT commonly define the joint injury. MRI is used selectively to investigate associated soft-tissue damage or a suspected fracture that is not visible on X-rays.

Treatment and the procedure

Some stable, well-aligned injuries are managed with a brace or cast and restricted loading. Displaced or unstable injuries may need repositioning and fixation with plates and screws. Supporting a depressed joint surface may require graft or a bone substitute. Severe swelling or soft-tissue damage may lead to temporary external fixation before definitive surgery. The plan considers the fracture, skin, associated injuries, health and previous function.

Benefits, risks and expectations

If surgery is planned, discuss bleeding, anaesthetic risks and complex regional pain syndrome as well as the risks specific to your injury. Your general health and the extent of surgery affect your personal risk.

Treatment aims to restore knee alignment and stability, and support healing of the joint surface. It cannot remove all cartilage damage caused by the injury.
Discuss infection, wound problems, nerve or vessel injury, compartment syndrome, blood clots, delayed healing, nonunion, loss of alignment, metalwork symptoms and further surgery.
Stiffness, persistent pain, instability or post-traumatic arthritis can occur despite healing. Recovery of strength and walking endurance takes longer than initial bone healing.

Rehabilitation and aftercare

Your written plan specifies weight bearing, permitted knee movement and brace settings. Do not change the brace limits or advance loading without approval. Physiotherapy teaches safe transfers, walking aids and the exercises appropriate to your restrictions. Protect the wound, check skin beneath the brace as instructed and follow clot-prevention advice. Arrange practical help and discuss stairs before discharge. Return to work and sport depends on symptoms, healing and functional assessment.

When to get urgent help

Attend A&E for sudden severe pain, rapidly increasing tight swelling, or a cold, pale, numb or weak foot. Report fever, wound discharge or spreading redness promptly.
New calf pain or swelling needs urgent assessment. Call 999 for chest pain or severe breathlessness.

Your consultation

Ask how the joint surface and ligaments are affected, why surgery or protected care is recommended and what loading is permitted. Consent and rehabilitation are tailored to your injury.

Your consent discussion

Use the patient pack to record your priorities, the proposed procedure, its alternatives, the benefits you hope for and risks that matter to you. A clinician will discuss your individual circumstances and complete the appropriate hospital consent process with you.

Reading or downloading a guide does not give consent. You can ask further questions, decline treatment or change your mind before the procedure.

Tibial plateau fractures