Tibia and femur form the knee joint, of which the surface contact with the femur for tibial plateau. Tibial plateau is an important structure knee load, once the fracture occurs, the inner and outer platform being uneven force, which will produce changes in osteoarthritis. It can be caused by direct violence or indirect violence, and can be divided into the following types:
 

1.Ⅰ types: simple tibial condyle fracture splitting.
 

2.Ⅱ type: lateral condyle fracture splitting merged platform collapse.
 

3.Ⅲ type: Central simple platform collapse fractures.
 

4.Ⅳ type: medial plateau fractures, can be expressed as the medial condyle fracture or split platform collapse tibia fractures alone.
 

5.Ⅴ type: tibia, lateral condyle fractures.
 

6.Ⅵ type: tibial plateau fractures while tibial metaphyseal or tibial shaft fractures.

 

The treatment of tibial plateau fractures is to restore the integrity of the ligaments and joints smooth surface, for the purpose of keeping the knee.

 

1. If there is no obvious simple cleavage fracture displacement, use lower limb plaster immobilization to fix for 4-6 weeks. If the shift is significant, open reduction should be applied. It can be fixed with cancellous bone screws or support plate in order to Maintain articular surface smooth or restore the tension collateral ligament.

 

2. If it is ccompanied by the collapse of the platform split fracture, open reduction should be applied. Skid since the collapse of the bone and restore articular surface smooth, while boning, keeping bone collapse the reset position, fixed by cancellous bone screws.

 

3. The collapse of the central tibial fractures, because it is not important weight-bearing area, For the collapse less than 1cm, just use the lower limb cast immobilization for 4-6 weeks.

 

4. The medial tibial plateau fractures with no shift can only be cast by immobilization for 4-6 weeks to functional training, If collapse is accompanied by fracture, merge cruciate ligament injury, open reduction should be applied in order to Lies flat platform and ligament tension, or anterior cruciate ligament reconstruction. Bone should be filled with cast immobilization for 4-6 weeks after surgery.

 

5. For the type Ⅴ fractures, unstable fractures, open reduction should be fixed with screws or cancellous bone screws.

 

6. Type Ⅵ fractures is also an unstable fracture, non-surgical therapy to be ineffective, with open reduction, five condylar plate or T-shaped plate. If fixation determine reliable, early postoperative control activities with CPM.

1. Try upfront joint exercise which plays a very important role for joint function. Pump training, after external fixation early quadriceps pain relief that is functional training, increase local blood circulation, prevent muscle atrophy, nerve, muscle adhesions, deep vein thrombosis and other complications.
 

2. Continue to strengthen the functional exercise after discharge, but must follow the "early activity, late load" principle. Generally three days dressing once, 12 days stitches, removing external fixation under the condition usually after 6-8 weeks.
 

3. Usually after the first day you can start under the guidance of CPM passive activities, gradually adapt to the initiative is not weight-bearing exercise. Negative important to wait until the fracture is completely healed before they can prevent fractures of the articular surface.