8/31/2023 0 Comments Occult tibial plateau fracturefracture)įat-suppressed sequences whenever possible (with the exception of plain T1-weighted sequence)Ĭoronal plain short tau inversion recovery (STIR) sequence (→ complementary method, especially for occult fractures, DD bipartite/tripartite patella vs. Optimized fracture typing (preferably according to AO classification) Longitudinal displacement and degree of malrotation, comparing sides – 3-D reconstruction: if joint surface involvement, subtraction of unfractured bones for an unobstructed view of position of fractured articular surfaceĮxact determination of localization and extent of fracture – 2-D reconstruction (sagittal and coronal): 1–2 mm slice thickness Suprapatellar longitudinal and transverse scanĪssociated injury to ligaments, tendons, muscles, menisci, joint capsuleįunctional test (abnormal mobility, instability)įracture diagnosis (gap width, joint surface irregularity, signs of consolidation) (→ complementary method, not clinically relevant for fracture diagnosis) H, i 3-D reconstruction can optimize the overall view, demonstrating the extent of fracture (bold arrow) of the posterolateral tibial plateau and the intercondylar eminence fragment (dotted arrow). 2.6 a–i Avulsion of the cruciate ligament and fracture of the tibial plateau.Ī, b This AP radiograph shows a bony avulsion of the anterior cruciate ligament (large arrow), lateral projection additionally shows a displaced fracture of the dorsal tibial plateau (small arrows).Ĭ Using MRI a T1 SE sequence shows the small bony fragment from the tibial avulsion of the anterior cruciate ligament and a surrounding hypointense bone bruise.ĭ, e 2-D CT reconstructions in the sagittal and coronal planes are best suited for showing the extent of the fracture of the dorsal tibial plateau as well as fragment position (small arrows).į, g This also applies to the corresponding planes on the T1 SE sequence. Local spontaneous pain, tenderness, and pain with movementĭiagnostic Evaluation ( Figs. Grade VI: comminuted fracture involving medial and lateral joint surfaces and possibly fibular head fracture Grade V: undisplaced vertical coronal anterior or posterior fracture without depression Grade IV: displaced entirely medial joint surface depression without comminution Grade III: displaced vertical sagittal fracture with central depression of medial or lateral joint surface and sometimes proximal fibular head fracture Grade I: undisplaced vertical sagittal fracture Tibial Plateau Fracture Classification (Based on Hohl) Grade IV: comminuted fracture involving medial and lateral joint surface and proximal fibula fracture Grade III: vertical or wedgeshaped fracture with central depression of medial or lateral joint surface and proximal fibula fracture Grade II: central depression of medial or lateral joint surface Grade I: undisplaced vertical or wedgeshaped fracture Tibial Plateau Fracture Classification (Based on Mueller) – differential diagnosis (DD) bipartite/tripartite patella (congenital, asymptomatic, predominantly among men, unilateral in 50%, craniolateral in three-quarters of cases, otherwise lateral or cranial, no hematoma/edema, no bone bruise)
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