Tibial Plateau Fractures in the Elderly

  • Krishna C. Vemulapalli
  • Joshua C. Rozell
  • Joshua L. GaryEmail author
  • Derek J. Donegan
Part of the Aging Medicine book series (AGME)


In light of an ever-aging population, the incidence of osteoporotic fractures continues to rise. The challenges of reduction and fixation in osteopenic bone are well known to orthopedic surgeons. In this context, treatment of elderly tibial plateau fractures must be individualized to the patient and their injury. Low-energy fractures in low-demand patient may best be treated non-operatively with early mobilization. Higher-energy patterns or higher-demand patients should lead to stronger consideration of surgical treatment. Surgical treatment options include internal or external fixation or a combination of the two. While acute arthroplasty has been used for many other osteopenic fractures, especially those of the proximal femur, the benefits and indications of acute arthroplasty for tibial plateau fractures are unknown. Soft tissue compromise, prosthetic infection, and integrity of the extensor mechanism around arthroplasty components are concerns. The exact indications and benefits of each treatment remain unknown. We review these treatments and the data published that supports them to help the surgeon individualize treatment choice for the elderly patient.


Tibial plateau fractures in the elderly Elderly tibial plateau Osteoporosis ORIF External fixation in the elderly 

Supplementary material

Video 14.1

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Copyright information

© Springer Science+Business Media, LLC 2018

Authors and Affiliations

  • Krishna C. Vemulapalli
    • 1
  • Joshua C. Rozell
    • 2
  • Joshua L. Gary
    • 1
    Email author
  • Derek J. Donegan
    • 3
  1. 1.Department of Orthopaedic SurgeryUniversity of Texas Medical School at HoustonHoustonUSA
  2. 2.Department of Orthopaedic SurgeryUniversity of Pennsylvania Health SystemPhiladelphiaUSA
  3. 3.Department of OrthopaedicsHospital of the University of PennsylvaniaPhiladelphiaUSA

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