Tibial plateau fractures: evaluation with MR imaging

Thirty patients with 31 tibial plateau fractures, initially diagnosed with standard radiography, were further studied with biplane linear tomography and magnetic resonance (MR) imaging. Each fracture was categorized according to the Schatzker classification. The extent of comminution and articular depression was determined for each modality. MR images were also evaluated for the presence of accompanying meniscal and ligamentous injury. In each case, MR imaging was noted to be as effective as tomography in depicting the amount of articular depression. MR imaging was found to be more effective than tomography in determining the extent of comminution. Beyond demonstrating the fracture, MR imaging was capable of revealing associated ligamentous and meniscal injuries. There was an increased prevalence of accompanying soft-tissue injuries in those fracture types that are associated with more violent forces and as the extent of articular depression increased. MR imaging is a useful and effective means of preoperatively evaluating tibial plateau fractures.