Skip to main content
SpringerLink
Log in

Comparison of CT and MRI in patients with tibial plateau fracture: can CT findings predict ligament tear or meniscal injury?

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

(1) To determine the accuracy of computed tomography (CT) in the evaluation of ligament tear and avulsion in patients with tibial plateau fracture. (2) To evaluate whether the presence or severity of fracture gap and articular depression can predict meniscal injury.

Design and patients

A fellowship-trained musculoskeletal radiologist retrospectively reviewed knee CT and MRI examinations of 41 consecutive patients presenting to a level 1 trauma center with tibial plateau fractures. Fracture gap, articular depression, ligament tear and footprint avulsions were assessed on CT examinations. The MRI studies were examined for osseous and soft tissue injuries, including meniscal tear, meniscal displacement, ligament tear, and ligament avulsion.

Results

CT demonstrated torn ligaments with 80% sensitivity and 98% specificity. Only 2% of ligaments deemed intact on careful CT evaluation had partial or complete tears on MRI. Although the degree of fracture gap and articular depression was significantly greater in patients with meniscal injury compared with those without meniscal injury, ROC analysis demonstrated no clear threshold for gap or depression that yielded a combination of high sensitivity and specificity.

Conclusions

In the acute setting, CT offers high sensitivity and specificity for depicting osseous avulsions, as well as high negative predictive value for excluding ligament injury. However, MRI remains necessary for the preoperative detection of meniscal injury.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1a–h
Fig. 2a–f
Fig. 3a, b

Similar content being viewed by others

References

  1. Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968–1975. Clin Orthop Relat Res 1979;99:94–104.

    Google Scholar 

  2. Hung SS, Chao EK, Chan YS, et al. Arthroscopically assisted osteosynthess for tibial plateau fractures. J Trauma 2003;54:356–63.

    PubMed  Google Scholar 

  3. Gardner MJ, Yacoubian S, Geller D, et al. The incidence of soft tissue injury in operative tibial plateau fractures. A magnetic resonance imaging analysis of 103 patients. J Orthop Trauma 2005;19:79–84.

    Article  PubMed  Google Scholar 

  4. Yacoubian SV, Nevins RT, Sallis JG, Potter HG, Lorich DG. Impact of MRI on treatment plan and fracture classification of tibial plateau fractures. J Orthop Trauma 2002;16:632–7.

    Article  PubMed  Google Scholar 

  5. Delamarter RB, Hohl M, Hopp E Jr. Ligament injuries associated with tibial plateau fractures. Clin Orthop Relat Res 1990;226–33.

  6. Moore TM, Meyers MH, Harvey JP Jr. Collateral ligament laxity of the knee. Long-term comparison between plateau fractures and normal. J Bone Joint Surg Am 1976;58:594–8.

    PubMed  CAS  Google Scholar 

  7. Gardner MJ, Yacoubian S, Geller D, Pode M, Mintz D, Helfet DL, Lorich DG. Prediction of soft-tissue injuries in Schatzker II tibial plateau fractures based on measurements of plain radiographs. J Trauma 2006;60:319–23.

    Article  PubMed  Google Scholar 

  8. Burri C, Bartzke G, Coldewey J, Muggler E. Fractures of the tibial plateau. Clin Orthop Relat Res 1979;84–93.

  9. Honkonen SE. Indications for surgical treatment of tibial condyle fractures. Clin Orthop Relat Res 1994;302:199–205.

    PubMed  Google Scholar 

  10. Kode L, Lieberman JM, Motta AO, Wilber JH, Vasen A, Yagan R. Evaluation of tibial plateau fractures: efficacy of MR imaging compared with CT. Radiology 1994;163:141–7.

    CAS  Google Scholar 

  11. Holt, MD, Williams LA, Dent CM. MRI in the management of tibial plateau fractures. Injury 1995;26:595–9.

    Article  PubMed  CAS  Google Scholar 

  12. Brophy DP, O’Malley M, Lui D, Denison B, Eustace S. MR imaging of tibial plateau fractures. Clinical Radiology 1996;51:873–8.

    Article  PubMed  CAS  Google Scholar 

  13. Shepherd L, Abdollahi K, Lee J, and Vangsness CT Jr. The prevalence of soft tissue injuries in nonoperative tibial plateau fractures as determined by magnetic resonance imaging. J Orthop Trauma 2002;16:628–31.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway, Bronx, NY, 10461, USA

    Leonora W. Mui, Eliyahu Engelsohn & Hilary Umans

  2. 8 Rockridge Road, Ardsley, NY, 10502-1909, USA

    Hilary Umans

Authors
  1. Leonora W. Mui
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eliyahu Engelsohn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hilary Umans
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hilary Umans.

Rights and permissions

Reprints and permissions

About this article

Cite this article

W. Mui, L., Engelsohn, E. & Umans, H. Comparison of CT and MRI in patients with tibial plateau fracture: can CT findings predict ligament tear or meniscal injury?. Skeletal Radiol 36, 145–151 (2007). https://doi.org/10.1007/s00256-006-0216-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-006-0216-z

Keywords

Search

Navigation