Tibial Plateau Fractures Clinical Presentation

Updated: Jul 05, 2018
  • Author: Srinivasa Vidyadhara, MBBS, DNB, MS(Orth), DNB(Orth), FNB(SpineSurg), MNAMS; Chief Editor: Thomas M DeBerardino, MD  more...
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Presentation

History and Physical Examination

Full clinical assessment is required, including evaluation of the soft tissues to determine whether a compartment syndrome is present and whether the patient has sustained a neurovascular injury. Gentle stress testing can be performed with the leg in extension to evaluate the stability of the ligaments and to assess any sign of fracture displacement.

Approximately 50% of knees with closed tibial plateau fractures have injuries of the menisci and cruciate ligaments that usually necessitate surgical repair. Because of the valgus stress at the moment of impact, the medial collateral ligament is at greater risk than the lateral collateral ligament; however, disruption of the lateral collateral ligament is of grave concern because of possible injuries to the peroneal nerve and the popliteal vessels. Dislocation-relocation injuries are more common with medial plateau injuries and carry an increased risk of peroneal nerve damage.