Role of MDCT in evaluation of proximal tibia fractures

Introduction: Proximal tibia articular fractures can be caused by motor vehicle accidents or bumper strike injuries ;however, sports injuries, falls, and other less violent trauma frequently produce them, especially in elderly patients. The treatment for these fractures aims to achieve anatomical reduction of the joint surface and stable osteosynthesis in order to enable early mobilization, so as to prevent complications such as joint stiffness and post-traumatic arthrosis. The diagnosis of tibial plateau fractures is typically made on plain radiographs. AP and lateral are standard examinations. Less frequently, oblique views are obtained but are not routine. CT scans have largely supplanted the need for these adjunctive views. CT has been shown to be more reliable in classifying the fracture and hence on deciding a treatment plan. 3D reconstructions have been increasingly used and found to demonstrate spatial relationships of fracture fragments better than plain radiographs. Materials and Methods: Fourty consecutive patients of knee with proximal tibia fractures were taken up for study. All patients were subjected to plain radiography and non-contrast MDCT. The fractures were classified according to schatzkers classification .In all patients surgical plan and sequence of reduction was planned preoperatively using both techniques successively and then correlated with intraoperative findings and postoperative plain film. Results: The fractures were underestimated in 16 (40%) cases with plain films. The surgical plan based on plain film was modified in 12 (30%) cases due to precise preoperative imformation on CT. Conclusion: The use of MDCT is advisable for the accurate classification and management of tibial plateau fractures.