Aims and objectives
Many clinical classifications of tibial plateau fractures (Schatzker (1974),
Hohl (1967),
AO (1995) classifications,
etc.) have been put forward from time to time.
Aim of classifications should be its clinical practical utility.
It is know that MRI is more accurate in determining the type of the fracture and in accurate measurement of displacement and depression of fragments,
in the assessment of soft tissue injury.
The objective of our study was to create the MRI classification of tibial piateau fractures for better diagnosis characteristics of fracture,...
Methods and materials
Seventy-three consecutive patients with tibial plateau fractures were investigated by standard radiography,
computed tomography and MRI before treatment.
The reasons for grouping in our MR-classification were:
I.
Type of tibial plateau fracture (site of the fracture,
the number of fragments and their displacement in different planes,
the presence of impressions,
and the depth of the articular surface); II.
Menisci and ligaments injuries (which ligament is damaged,
its location and the type of injury; which the meniscus is damaged,
location of injury).
Results
Among of seventy-three patients in fifty-two (71%) patients were found ligaments and menisci tears.
All MRI results were confirmed by arthroscopy.
According to our classification,
the patients (n=73) on the complex imaging results were distributed:
I.
Type ot fracture:
type 1.
Pure depression of lateral tibial plateau (n=18; 24,7%);
type 2.
Split of lateral tibial plateau (n=2; 2,7%);
type 3.
Split depression fracture of lateral tibial plateau (n=23; 31,5%);
type 4.
Pure depression of medial tibial plateau (n=4; 5,5%);
type 5.
Split of medial plateau...
Conclusion
We have proposed a classification,
that contains all types of fractures with full characteristics of fracture and all meniscal and ligament injuries.
It is necessary for better diagnosis of this fractures for carrying treatment.
Availability of tears of the ligaments and menisci can change the course and tactics of the of surgical treatment.
References
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Operative treatment of 109 tibial plateau fractures: five- to 27-year follow-up results.
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Gardner MJ,
Geller D,
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The incidence of soft tissue injury in operative tibial plateau fractures: a magnetic resonance imaging analysis of 103 patients.
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Crawford R,
Walley G,
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Magnetic resonance imaging versus...