tibial plateau fracture in Tunisia

Definition of Tibial Plateau Fracture

$tibial plateau fracture tunisia price affordable$ A tibial plateau fracture is a break of the larger bone of the lower leg below the knee that enters the knee joint itself. It is rare to break only the bone. This is an injury that can affect the bones, meniscus, ligaments, muscles, tendons, and skin around the knee. All these structures must be considered when diagnosing and treating these injuries. These fractures usually result from high-energy injuries such as car accidents in younger patients and most often from falls in elderly patients. The tibia can be broken into several pieces or simply crack slightly depending on the quality of the bone and the type of injury.

Tibial Plateau Anatomy

The tibial plateau is an important part of the knee joint as it supports your body weight when you walk, run, and jump. The ligaments and tendons around the knee all connect to the plateau. They need this bone to be strong and straight to function properly. It is also covered with a layer of cartilage that allows the knee to glide smoothly. If this is disrupted, arthritis can occur.

Non-Surgical Treatment of Tibial Plateau Fracture

Some fracture patterns and types do not require surgery for the bone to heal. Small breaks or those with good overall alignment can often be treated without surgery. Non-surgical treatment is also recommended for adults with poor general health, fragile or chronically infected skin, and less active patients. Knee immobilizers, hinged knee braces, and casts are all used to treat these injuries depending on the fracture type and patient characteristics.
If non-operative care is chosen, regular follow-up care for physical examination and X-rays is important to ensure the fracture remains in good position and heals appropriately. Reducing or stopping smoking and closely controlling blood sugar if you are diabetic is important for the healing process. A fall or continued non-compliance with the cast, bracing, or early walking against medical advice can cause the bones to move and require surgery.
Depending on health and injury type, this bone can take 3 to 4 months to heal without surgery. Physical therapy for knee range of motion begins about 6 weeks once the bone has healed enough to prevent displacement with movement.

Surgical Alternatives for Tibial Plateau Fracture

Surgeons may recommend surgery to repair the broken tibia if the pieces are displaced, if the bone is sticking out of the skin, if the skin is at risk of dying, or if the bone is unstable due to the fracture type.
The injury is usually fixed with metal plates and screws placed through a large incision. The fracture type usually dictates the types of incisions and the number of plates and screws needed. Sometimes bone graft or types of bone cement are needed to support the joint surface. During these surgeries, the injured meniscus or tendons are also repaired. Surgery typically takes 1 to 2 hours. Most patients are admitted overnight after these types of procedures to monitor for any breathing problems or development of compartment syndrome.
In cases where there is severe injury to muscles, nerves, or arteries or if there is significant contamination from dirt, rocks, or grass from the injury, some patients require external fixation before definitive surgical treatment. This is an operation where metal pins are placed in the bone through small cuts and connected to bars to give some stability to the bone. After secondary operations to clean the wound or recover from skin injuries, the external fixator can be removed and plates and screws can be placed.
Ideally, surgeons like to perform this surgery acutely or at most within 1-2 weeks of the injury. This gives patients time to seek a second opinion regarding treatment if more information or additional feedback from the surgeon is desired.
After surgery, patients are often placed in a knee immobilizer or hinged brace. They cannot bear weight immediately. Patients will need to use a walker or crutches for the first 6 weeks. Gentle movement of the knee is started early to prevent stiffness. Gradually, this movement is increased and physical therapy begins about 6 weeks after surgery if the patient has residual knee or ankle stiffness. Your doctor may decide to put you on a blood thinner after surgery for 2 to 6 weeks depending on your risk factors.

Surgical Complications

Complications can occur with any surgery, no matter how small. There is always a risk of infection. The risk is much greater for larger, more contaminated traumatic wounds. A dose of antibiotics given before surgery helps minimize this risk. There is always a risk of injury to blood vessels or nerves. This is reduced by having an experienced surgeon involved in your care. As mentioned above, compartment syndrome can occur as a result of the injury and evolve during surgery. This requires additional surgery to release pressure on the muscles. Non-compliance with weight-bearing restrictions, too much movement, or falls can cause the metal to tear out of the bone or the fracture to break. It is always possible that the bone may not heal and additional surgery will be needed. This is usually associated with non-compliance.

Outcomes

Most people with this type of fracture do very well and return to their previous activities and functions. At 6 weeks, patients are extremely comfortable. They cannot be released to full activities such as manual labor, skiing, and motocross until about 4 months. An aggressive return to activity too early can lead to re-fracture, hardware failure, or non-union. If fractures heal unevenly, post-traumatic arthritis can occur and require knee replacement in the future.