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Why is higher displacement amenable to conservative treatment in tibial plateau fractures compared to other intra-articular fractures?

Asked by Srinivas

There may not be an exact answer. But it is believed that the greater amount of soft tissue buffer afforded by an intact (or repaired) meniscus is protective.

Another reason might be the relative lack of constraint of the knee compared to more constrained ball and socked joints like hip that are much less tolerant of articular incongruencies.

The operative indications for tibial plateau fracture are:
  • Articular depression > 5-10 mm
  • Condylar widening > 5mm
  • Varus/valgus instability >10 deg
  • Medial plateau fractures  
  • Bicondylar fractures
Reference: Orthobullets

For Schatzker classification, refer to: Schatzker classification for Tibial plateau fracture : Mnemonic | Epomedicine