Cast and brace care for a tibial plateau fracture

The tibial plateau forms the upper surface of the shin bone inside the knee. A stable fracture may be managed without an operation, whereas displaced joint fragments, instability or associated soft-tissue damage can make fixation more appropriate. Swelling may lead to temporary splinting before definitive support.

This fracture involves a weight-bearing part of the knee joint. The cast or brace limits motion, while restrictions on standing and walking reduce load through the healing surface. A brace may later allow controlled knee movement if the treating clinician considers the fracture stable enough.

Repeat examination and imaging can monitor position as swelling settles. Because the knee and ankle can stiffen during protection, rehabilitation must balance joint movement with the need to avoid shifting the fracture.

Follow the prescribed weight-bearing status exactly; do not test the leg because pain is improving. Use crutches or a walking frame as taught, keep floors clear, and plan safe access to washing and sleeping areas. Elevate the leg as advised and keep rigid support dry.

Check the toes for normal colour, warmth, feeling and movement. Perform only approved exercises for the toes, ankle, thigh or knee. Attend reviews so the support, skin, circulation, fracture position and mobility aid technique can be reassessed.

Seek urgent care for rapidly worsening or severe pain, a very tight swollen leg, new numbness or weakness, or toes that become pale, blue or cold. Sudden breathlessness or chest pain needs emergency attention.

Contact the treating team if the cast or brace cracks, becomes wet or loose, causes skin rubbing, or no longer holds the leg as shown. Fever, wound discharge, spreading redness, a new fall or accidental weight placed through the leg also warrants prompt advice.

Ask whether the joint surface is displaced, whether ligaments or cartilage are affected, and why a cast, brace or operation is recommended. Get the weight-bearing instruction in clear terms and confirm how to manage stairs and transfers.

Discuss when repeat imaging is planned, when knee movement may start, and whether rehabilitation will be needed. Before resuming driving, work or sport, request specific functional milestones rather than relying only on a calendar date.