الفهرس 
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Abstract
Tibial plateau fracture is an intra-articular fracture for which the treatment requires not only anatomical reduction but also reliable fixation to maintain the position of the articular surface, allowing patients to receive early function rehabilitation (1-3) However, inappropriate treatment of the fracture can lead to limited movement, articular degeneration, and long-term pain (1-3). The most common cause of injury is road traffic accidents (RTA) especially in young people followed by Falling from height (FFH), Low energy trauma like twisting injuries are the main cause of fracture in elderly (Osteoporotic patients). There are many fracture classifications which describe tibial plateau fractures, the most widely used is the Schatzker classification. Lateral plateau fractures are more frequent than medial. Schatzker type II and III fractures are the most common tibial plateau injuries resulting from axial loading and bending forces. Articular surface depression is widely seen in older patients because of osteoporosis. In adults, non-surgical treatment has a little or no role in treatment of tibial plateau fractures due to high incidence of malunion, nonunion, posttraumatic arthritis and complications of prolonged recumbence in bed. In this study , we used subchondral one third tubular plate as a raft for elevation of the depressed tibial plateau fractures especially of high fragmentation to treat thirty patients grouped to 21 males (70%) and nine females (30%) with an average age of 35.5 ( range from 21 to 50 years ). The mechanism of injuries was as follows; 16 were road traffic accident (53%), nine were falling from height (30%) and five were twisting injuries (17%). Time lag between the date of hospitalization and date of operation ranged from one to 14 days with a mean value (± SD) of 3.33 (±0.33) days. The left side was affected in 18 patients (60%) while the right side was affected in 12 patients (40%). Regarding the fracture classification, 20 patients had Schatzker type II (67%), six patients had Schatzker type III (20%), three patients had Schatzker type IV (10%) and one patient had Schatzker type V (3%). All patients were followed up for 6−12 months and assessed clinically and radiologically according Rasmussen score. The radiological and functional results were promising. According to functional Rasmussen score, satisfactory results were 86.66%, (53.33% were excellent & 33.33% were good) while non-satisfacory results were 13.34%, (6.67% fair & 6.67% poor). According to radiographic Rasmussen score, satisfactory results were 83.34%, (56.67% were excellent & 26.67% were good) while non-satisfactory results were 16.66%, (10% fair & 6.66% poor). No significant difference was found between the studied groups regarding age, sex, side affected, type of fracture and type of trauma. The final outcome was significantly affected by smoking and comorbidities. Active and passive rehabilitation started from the day after the operation. The integrity of the articular surface and bone healing was assessed using follow up radiographs. After significant bone healing was achieved, Partial and full weight bearing were encouraged at six and 12 weeks, respectively, at the outpatient clinic.