Tibial plateau fracture in a female soccer player: a case study.
In general, tibial plateau fractures are rarely associated with noncontact, twisting, injuries to the knee in athletics. A 23-year-old woman sustained a noncontact valgus injury to her left knee while playing indoor soccer. Evaluation on-site and the following morning revealed no deformity and only mild pain over the anterolateral tibial plateau. All stress tests of the knee were negative. A 2+ effusion was noted the day after injury, causing us to suspect an internal derangement of the left knee. A nondisplaced tibial plateau fracture was confirmed by radiographs. The patient was treated non-operatively with a hinged knee brace and protective weight bearing with axillary crutches. Ten weeks following the injury, radiographs revealed a healed fracture, and the patient was instructed to gradually increase her athletic activity. The mechanism of injury and symptoms suggested injury to the tibial collateral ligament and anterior cruciate ligament. The physical examination findings, however, led us to believe otherwise. It is important to recognize that valgus stresses to the knee can result in damage to structures other than the soft tissues (ie, tibial collateral ligament). This injury resulted in a nondisplaced tibial plateau fracture that healed uneventfully with appropriate nonoperative treatment.
Jeff A. Giulietti is Graduate Student in the Master of Physical Therapy Program at Slippery Rock University, Slippery Rock, PA 16057.
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