A tibial plateau fracture involves a break in the shin bone at its upper end, where it forms the knee joint. These injuries often result from high-energy trauma, like falls or car accidents, and can range from a simple crack to a shattered bone. Surgical intervention is frequently necessary to repair the bone and restore joint alignment, which typically results in a visible scar. Managing this surgical scar is a common concern for individuals recovering from this type of injury.
Characteristics of Tibial Plateau Fracture Scars
A surgical scar initially appears as a red, raised line along the incision site. Within 12 to 18 months, the scar matures, becoming flatter, paler, and less noticeable. Its exact appearance is influenced by several factors, including the incision’s location, often over the knee joint, a high-motion area that experiences tension during healing.
The size and depth of the incision, determined by the fracture’s complexity and surgical approach, affect scar prominence. Individual healing characteristics, such as skin type and genetic predisposition, influence scar development. Surgical techniques, including wound closure precision, influence the final scar.
Scar healing progresses through stages. The initial inflammatory phase, lasting a few days to weeks, involves redness and swelling. This is followed by the proliferative phase, where new collagen fibers are laid down, making it appear raised and sometimes itchy. Finally, the remodeling phase, over months to years, sees collagen fibers reorganize, leading to a flatter, less conspicuous scar.
Caring for Your Surgical Scar
Immediate post-operative care focuses on keeping the incision clean and dry to prevent infection. Following your surgeon’s instructions for dressing changes is important to protect the healing wound. Protecting the new scar from direct sun exposure is also necessary, as ultraviolet radiation can cause hyperpigmentation, making it darker.
Once the incision has fully closed and stitches or staples are removed, long-term scar management can begin. Gentle massage techniques help prevent adhesions, bands of scar tissue that restrict movement and cause discomfort. Massaging the scar with light to moderate pressure, in circular motions or along its length, for 5-10 minutes, two to three times daily, can improve flexibility and reduce stiffness.
Silicone sheets or gels are recommended for scar care, as they create a moist environment that flatten and soften the scar, reducing redness. These products work by hydrating the scar tissue and providing gentle pressure. Consistent application for several months is important for noticeable improvement.
Regular moisturization with a gentle, fragrance-free lotion keeps the skin supple and supports healing. Continued sun protection, using broad-spectrum sunscreen with an SPF of 30 or higher or covering the scar with clothing, is important for at least a year after surgery to prevent discoloration. Consistency in these care practices over several months improves the scar’s appearance and pliability.
Addressing Scar-Related Issues
While most scars heal well with proper care, some individuals may develop issues. Hypertrophic scars are raised, red, and sometimes itchy, but they remain confined to the original wound boundary. They often develop weeks to months after surgery due to an overproduction of collagen during healing.
Keloids are a more aggressive form of scarring, also raised, red, and itchy, but they extend beyond the original wound margins and continue to grow. Both hypertrophic scars and keloids can cause discomfort and affect appearance. The risk of developing these is influenced by genetics, skin type, and injury location.
Nerve impingement or sensitivity around the scar can occur due to nerve damage during injury or surgery, or scar tissue forming around nerves. This can manifest as numbness, tingling, or heightened pain when touched. This nerve involvement can sometimes persist even after the scar has matured.
If you experience persistent pain, numbness, significant scar changes, or if it becomes increasingly raised, discolored, or itchy, seeking professional medical advice is recommended. A healthcare provider can assess the scar and suggest appropriate interventions, which may include topical treatments, injections, or in some cases, surgical revision.