Analysis of injuries to the proximal tibia based ondifferent diagnostic methods: Diagnostic difficulties

摘要

Background:Fractures of the proximal tibia involve the lateral condyle in 75-80% of cases. Intercondylar eminence fractures and avulsion injuries involve the tibial side of the attachment of the cruciate ligaments. The aim of this study was an analysis of injuries to the proximal tibia.Material/Methods:A radiologist and an orthopedic surgeon analyzed the radiographic, CT, and MR images of 23 patients from both the technical and the diagnostic aspect.Results:Partial fracture of the tibial plateau was diagnosed in 12 cases, including fractures of the lateral condyle in 11 cases, and isolated fractures of the lateral condyle in 4 cases. Fracture of the medial condyle was diagnosed in 1 case. Isolated avulsional fractures of the intercondylar eminentia were diagnosed in 2 cases. Multifragmentary fractures of the tibial plateau and metaphysis werediagnosed in 6 cases.Conclusions:In our opinion the best diagnostic method was CT investigation made according to a specified protocol and analyzed with radiographic images in two projections. MR was an additional method in problematic and complicated cases, such as subtle fractures of the tibial plateau with cartilage damage or when the CT was not diagnostic.