Tibial Plateau Fractures

From the WebMD Archives

By Amy McGorry

Basketball fans pondered the fate of Kobe Bryant after the Lakers announced that the star player was out for the season with a lateral tibial plateau fracture. This complicated fracture occurs on the top surface of the shinbone in the knee joint. It's like a fault line in earth’s surface that can create a “mini earthquake” in your knee, damaging the stability and structures of the joint.

Tibial plateau fractures are serious injuries, and are common in high-impact sports like football, rugby and basketball. Twisting motions and motor vehicle accidents can also cause a tibial plateau injury.

When Tibial Plateau Fractures Are A Pain

The tibial plateau is an important weight-bearing part of the body that connects the thighbone (femur) to the shinbone via ligaments.

A fall from a height or a hit to the thigh can drive the femur into the shinbone, creating a compressive force. This force causes the bone to crack. The crack can stay in position (aka "nondisplaced") or break off into pieces and shift the alignment (aka a "displaced fracture"). It can tear the surrounding ligaments such as the anterior cruciate ligament (ACL), the collateral ligaments (MCL and LCL) and the meniscus.

Athletes suffering from tibial plateau fractures usually complain of swelling, pain and an inability to walk or move the leg. A major concern with this injury is having swelling compress the nerves and blood vessels inside the knee joint. This so-called “compartment syndrome” can lead to death of tissues. Complaints of abnormal sensation or tingling should not be ignored. Neurovascular screens are recommended.

Why You're Sidelined

Muscle imbalances throughout your hip, knee and ankle can contribute to a tilting angle of the shinbone that creates points of pressure on the plateau. Suddenly, while channeling your inner Kobe on the court, you land hard on your feet, which drives the femur into the shinbone. One side of the tibia plateau may feel more of the impact due to the force angle as well as the existing tilt. Weak and tight muscles don’t allow for efficient absorption of the shock. The pressure overpowers the bone’s strength. A fracture then occurs.

Malnutrition and osteoporosis can also leave athletes at risk for tibial plateau fractures. These fractures are frequently monitored to ensure the knee stays properly aligned throughout the recovery process to avoid issues like arthritis and permanent movement restrictions. Athletes are typically not allowed to put weight on the leg for several weeks. Recovery can take several months.

How To Stay In The Game

Hits and falls aren’t always preventable, but following a program that builds strength and flexibility in your ankles, knees and hips may help prevent injuries by keeping bones strong and able to absorb impact.

Try these exercises:


  • Squat until the thighs are parallel to the floor
  • Don’t let knees cave in or out
  • 2 sets of 10 repetitions

Jumping Box

  • Jump in a square formation
  • Don’t let knees cave in or out
  • 10 repetitions

Side-Lying Lifts

  • Lie on one side with your back against the wall
  • Bend bottom knee
  • Lift the straight, top leg up while keeping the heel on the wall
  • 2 sets of 10 repetitions

Always check with a physician before starting an exercise program.