[Value of magnetic resonance tomography (MRI) in diagnosis of triplane fractures of the distal tibia].
The rare transitional fractures occur in adolescents at a time of incomplete dosis of the epiphysis. The anatomy of this fracture type is complex with the fracture line running in multiple planes. Conventional plain film radiographs often underestimate the extent and geometry of the fracture due to its transverse components. This study was performed to asses the benefit of MR-imaging compared to plain film radiographs in diagnosis and analysis regarding fracture-type, anatomy and dislocation of fracture. During a time period of 18 months we treated 15 patients with a fracture of the distal tibial epiphysis. In addition to plain film radiographs they got MRI of the distal tibia. Plain film radiographs and MRI were anonymized and diagnosed by 2 surgeons and 2 radiologists. 12 transitional fractures were diagnosed in plain radiographs as well as MRI, but regarding our criteria as above, we found two wrong classifications of fracture-type, an underestimation of fracture dislocation of an average of 0.5 mm in plain film radiographs and two rotational dislocations were missed. The MRI was found to provide anatomical detail and information superior to plain film radiographs.
Seifert
J
J
Klinik für Unfall- und Wiederherstellungschirurgie, Ernst-Moritz-Arndt-Universität, Friedrich-Loeffler-Strasse 23b, 17487 Greifswald.
Laun
R
R
Paris
S
S
Mutze
S
S
Ekkernkamp
A
A
Ostermann
P A
PA
D000293:Adolescent; D016512:Ankle Injuries / Q000145:classification / Q000175:diagnosis* / Q000601:surgery; D002648:Child; D004838:Epiphyses / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D004204:Joint Dislocations / Q000145:classification / Q000175:diagnosis / Q000601:surgery; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013978:Tibial Fractures / Q000145:classification / Q000175:diagnosis* / Q000601:surgery