[Tibial head fractures in the elderly]

In contrast to younger patients, tibial head fractures of the elderly usually result from minor trauma. In these patients, fractures of the tibial plateau are frequently seen and classified according to the Tscherne classification. In addition to plain radiographs which consist of an a.p. and a lateral view, a CT-scan is an obligatory part of the preoperative diagnostic. The therapeutic management is strongly depending on the psychic and physical condition of the patient, the fracture morphology, the decreased bone mineralization and the soft tissue damage. Low bone density requires rigid implants to provide a stable osteosynthesis. Metaphyseal defects have to be augmented with synthetic bone substitutes to avoid secondary loss of reduction. Early mobilization should be achieved to decrease the risk of serious complications.