What is the anatomy of tibial plateau fractures?

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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Answer

The knee is a complex joint, exposed to forces that can exceed five times the weight of the body. The joint has enhanced mobility at the cost of stability. The proximal tibia expands from the diaphysis through a metaphyseal flare. Contact is made with the head of the fibula in the posterolateral quadrant. The surface of the tibial plateau has a medial and a lateral weightbearing portion and an intercondylar eminence, which is both nonarticular and nonweightbearing. The medial plateau is generally larger than the lateral plateau.

The intercondylar eminence provides attachment to the medial and lateral menisci and the anterior and posterior cruciate ligaments.

The normal knee is in physiologic valgus alignment. Most of the load transmitted across the knee is medial to the eminence, and therefore, the knee has stronger cancellous bone.

Because the medial condyle is rounded as compared with the lateral condyle, some of the anterior articular surface of the lateral plateau is exposed, especially during extension. This causes the lateral plateau to be more susceptible to bone injury and is the reason why fractures of the lateral plateau are more common than those of the medial plateau.


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