Working Diagnosis:
Stress fracture of tibial plateau
Treatment:
Patient wore a knee brace with no weight bearing for 1 week. After 1 week she progressed to partial weight bearing as tolerated. After able to fully bear weight, she resumed low-impact cardiovascular activities as tolerated. Pain was managed with acetaminophen.
Outcome:
Pain was well managed with acetaminophen. She was off the analgesic medication after 2 weeks
After week 1, she started walking with limited weight bearing. Over the next three weeks, she progressively increased her weight bearing
At week 4, patient was able to fully bear weight. She was also pain free. Low-impact cardiovascular activity was done for the next 4 weeks.
The patient was able to begin running at the end of treatment.
Author's Comments:
Tibial plateau fractures may appear unremarkable on initial X-ray. If clinical suspicion is high, an MRI can detect bone bruising, and x-ray should be repeated. With proper treatment patients can return to play with no limitations.
Return To The Case Studies List.