[Value of MRI in preoperative diagnostics of proximal humeral fractures compared to CT and conventional radiography].
OBJECTIVE
The diagnostic value of X-rays, computed tomography (CT) and magnetic resonance imaging (MRI) for proximal humeral fractures (PHF) was compared in order to test the hypothesis that MRI gives relevant additional information.


METHODS
In this study 30 displaced PHFs were investigated with X-ray, CT and MRI procedures. Fracture analysis was performed and the diagnostic values of the three methods were compared to each other. In the MRI relevant musculotendinous concomitant injuries and prognostic factors of the head perfusion were also evaluated.


RESULTS
In 7 out of 30 PHFs the X-rays did not show the correct number of fragments. The posteromedial metaphyseal extension and the caput-diaphysis angle were measured to be significantly greater in the X-rays than in CT and MRI. Relevant additional information obtained by MRI were 7 out of 30 rotator cuff tears and 11 out of 30 differentiated medial periostal hinges.


CONCLUSIONS
X-ray imaging is the basis method for the diagnosis of PHF but needs further multiplanar imaging to demonstrate complete fracture patterns. Imaging of fractures is equally good for MRI and CT and MRI also provides additional therapy-relevant information about the rotator cuff and head perfusion.
Voigt
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C
Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH, Hannover, Humboldtstr. 5, 30169, Hannover. christine.voigt@friederikenstift.de
Ewig
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M
Vosshenrich
R
R
Lill
H
H
D000368:Aged; D000369:Aged, 80 and over; D017759:Fractures, Malunited / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012784:Shoulder Fractures / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed / Q000379:methods*