AJR:193, November 2009
Antti O. T. Mustonen, Mika P. Koivikko, Martti J. Kiuru, Jari Salo, Seppo K. Koskinen
OBJECTIVE. The purposes of this retrospective study were to elaborate our experience in postoperative MDCT of tibial plateau fractures, to establish the frequency of these fractures and the indications for MDCT, and to assess the common findings and their clinical importance.
MATERIALS AND METHODS. A total of 782 knee injuries were imaged with MDCT at a level 1 trauma center over 86 months. A total of 592 knees had a tibial plateau fracture; 381 of these fractures were managed surgically, and postoperative MDCT was performed on ' 36 of these knees (9%). At postoperative image analysis, an orthopedic surgeon evaluated re_duction as good or suboptimal using the first postoperative radiographs. Fracture healing was determined as complete ossification, partial ossification, or nonunion on MDCT images ac_quired later in follow–up. The MDCT findings were compared with the radiographic findings to assess the usefulness and clinical importance of MDCT.
RESULTS. The main indications for MDCT were assessment and follow–up of the joint articular surface and evaluation of fracture healing. Orthopedic hardware caused no diagnos_tic problems at MDCT. Postoperative MDCT revealed additional clinically important infor_mation on 29 patients (81%), and 14 patients (39%) underwent reoperation.
CONCLUSION. Postoperative MDCT of tibial plateau fractures is performed infre_quently, even in a large trauma center. When it is performed, however, because of suspicion of increasing articular step–off or fracture nonunion, postoperative MDCT reveals clinically significant information in most cases.