Postoperative MDCT of tibial plateau fractures

The purposes of this retrospective study were to elaborate our experience in postoperative MDCT of tibial plateau fractures, to establish the frequency of these fractures and the indications for MDCT, and to assess the common findings and their clinical importance.

A total of 782 knee injuries were imaged with MDCT at a level 1 trauma center over 86 months. A total of 592 knees had a tibial plateau fracture; 381 of these fractures were managed surgically, and postoperative MDCT was performed on 36 of these knees (9%). At postoperative image analysis, an orthopedic surgeon evaluated reduction as good or suboptimal using the first postoperative radiographs. Fracture healing was determined as complete ossification, partial ossification, or nonunion on MDCT images acquired later in follow-up. The MDCT findings were compared with the radiographic findings to assess the usefulness and clinical importance of MDCT.

The main indications for MDCT were assessment and follow-up of the joint articular surface and evaluation of fracture healing. Orthopedic hardware caused no diagnostic problems at MDCT. Postoperative MDCT revealed additional clinically important information on 29 patients (81%), and 14 patients (39%) underwent reoperation.

Postoperative MDCT of tibial plateau fractures is performed infrequently, even in a large trauma center. When it is performed, however, because of suspicion of increasing articular step-off or fracture nonunion, postoperative MDCT reveals clinically significant information in most cases.