Plateau fractures

Plateau fractures

(CME points)

Scientific Secretary: Dr. Sohrab Kihani

2019   September  19   , Thursday

8:00  am- 12:30 pm

Conference hall of the Iranian Orthopedic Surgeons Association office

Plateau fractures

Speaker: Dr. Reza Minaei Nowshahr, 
Assistant Professor of Shahid Beheshti University of Medical Sciences; Orthopedic Specialist; Knee Surgery Fellowship 

Plateau fractures, also known as tibial plateau fractures, are intricate and often challenging injuries that involve the upper surface of the tibia, which forms the knee joint with the femur. These fractures can result from high-energy trauma, such as falls from significant heights, motor vehicle accidents, or sports-related injuries, as well as low-energy trauma, particularly in older individuals with weaker bones. Plateau fractures are classified based on their severity, displacement, and pattern, and they can be further categorized into lateral or medial plateau fractures.


The tibial plateau plays a crucial role in weight-bearing and knee stability, making fractures in this region particularly concerning. These injuries can disrupt the normal mechanics of the knee joint, leading to issues such as joint instability, malalignment, and early-onset arthritis if not properly managed. The presentation of plateau fractures can vary widely, from mild pain and swelling to severe deformity and joint dysfunction. Therefore, a thorough clinical assessment and radiographic evaluation, often including X-rays and CT scans, are essential to accurately diagnose the extent of the fracture and plan appropriate treatment.


Treatment strategies for plateau fractures depend on factors such as fracture type, displacement, patient age, and overall health. Non-displaced or minimally displaced fractures may be managed conservatively with the use of knee immobilization, partial weight-bearing, and close monitoring. However, more complex fractures often require surgical intervention to restore joint alignment and stability. Surgical options range from open reduction and internal fixation (ORIF) using screws, plates, or pins to external fixation for severely comminuted fractures. The choice of surgical approach is guided by the specific fracture pattern and the surgeon’s expertise.


Postoperative rehabilitation is a crucial component of plateau fracture management. It aims to restore the range of motion, strength, and function of the injured knee while protecting the healing fracture. Physical therapy may begin shortly after surgery, focusing on gentle joint mobilization, muscle strengthening, and gradual weight-bearing progression. Close follow-up appointments are necessary to monitor the healing process, address any complications, and adjust the rehabilitation plan as needed.


In conclusion, plateau fractures are intricate injuries that can have significant implications for knee joint function and stability. Timely and accurate diagnosis, coupled with appropriate treatment, whether conservative or surgical, is essential to achieve the best possible outcomes. A comprehensive rehabilitation program further contributes to successful recovery and the restoration of normal knee function, helping individuals regain their quality of life after experiencing a plateau fracture.