What is a tibial plateau fracture?

The part of the knee involved

The top of the tibia (shin bone) is broad and relatively flat, which is why it is called the plateau. It has an inner (medial) and an outer (lateral) side, each covered with cartilage and cushioned by a meniscus. The rounded ends of the thigh bone sit on these two surfaces.

A fracture here is an intra-articular fracture, meaning it runs into the joint. If the surface heals with a step or a depression, the knee can become unstable or wear faster later.

How it happens

• High-energy injuries: road traffic collisions, including a pedestrian struck at bumper height, and motorbike or quad bike accidents in the desert
• Falls from height, for example from ladders, scaffolding or on construction sites
• Sports injuries with a heavy twisting or sideways force, such as skiing or contact sport
• Low-energy falls in older adults with osteoporosis, where even a simple fall onto a hard floor can be enough

Types of fracture

Surgeons describe these fractures by which side is affected and the pattern of the break. Some are a simple split, some a depression where the thigh bone has pushed the joint surface down like a dent, and some combine both. More severe patterns involve both sides of the plateau or separate the top of the tibia from the shaft below.

The outer side is affected most often. Injuries to the inner side, or to both sides, usually result from greater force and are more often associated with ligament, artery or nerve injuries.

Why specialist assessment matters

Treatment depends on how much the surface is displaced, whether the knee is stable and the condition of the soft tissues. A CT scan is usually needed to plan treatment, and an MRI helps assess the menisci and ligaments. At Aman Hospital in Doha, Dr. Gelber reviews these scans with you and explains whether the fracture can be treated in a brace or needs fixation.