MRI in the management of tibial plateau fractures

Twenty-one consecutive patients with fractures of the tibial plateau were investigated by standard radiography and magnetic resonance imaging (MRI) before treatment. It was found that MRI was more accurate in determining the classification of the fracture, in the identification of previously 'occult' fracture lines, and in accurate measurement of displacement and depression of fragments. This resulted in a change in the classification of 10 fractures (47.6 per cent) and so a change in the management of four patients (19 per cent). In addition, MRI permits the reliable identification of associated intra- and periarticular soft tissue injuries pre-operatively for the first time in this group of injuries, seen to be present in 47.6 per cent of this series. This is higher than previously reported. No problems were encountered with the imaging technique, and in view of the significant effect on patient management, the authors now consider it to be the imaging method of choice.