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Tibial plateau fractures: evaluation with MR imaging
B A Barrow1, W A Fajman, L M Parker
1Department of Radiology, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA 30335.
Summary
Magnetic resonance (MR) imaging effectively evaluates tibial plateau fractures, surpassing tomography in assessing comminution and identifying associated soft-tissue injuries. This advanced imaging aids in preoperative planning for complex fractures.
Area of Science:
- Orthopedic Surgery
- Radiology
- Medical Imaging
Background:
- Tibial plateau fractures are complex injuries requiring accurate preoperative assessment.
- Standard radiography may not fully delineate fracture comminution or associated soft-tissue damage.
Purpose of the Study:
- To compare the efficacy of biplane linear tomography and magnetic resonance (MR) imaging in evaluating tibial plateau fractures.
- To assess MR imaging's ability to detect comminution, articular depression, and associated ligamentous and meniscal injuries.
Main Methods:
- Thirty patients with 31 tibial plateau fractures underwent standard radiography, biplane linear tomography, and MR imaging.
- Fractures were classified using the Schatzker classification.
- Articular depression and comminution were quantified; MR images were analyzed for soft-tissue injuries.
Main Results:
- MR imaging was as effective as tomography in depicting articular depression.
- MR imaging was superior to tomography in determining fracture comminution.
- MR imaging identified associated ligamentous and meniscal injuries, with increased prevalence in high-energy fractures and greater articular depression.
Conclusions:
- MR imaging is a valuable tool for the preoperative evaluation of tibial plateau fractures.
- It provides comprehensive assessment of fracture severity and associated soft-tissue damage.
- This aids in surgical planning and improves patient outcomes.