The value of magnetic resonance imaging in the preoperative diagnosis of tibial plateau fractures: a systematic literature review.

Purpose: The outcome of a tibial plateau fracture (TPF) depends on the fracture reduction achieved and the extent of soft-tissue lesions, including lesions in the ligaments, cartilage, and menisci. Sub-optimal treatment can result in poor knee function and osteoarthritis. Preoperative planning is pr...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 49; no. 2; pp. 661 - 680
Autores principales: Thürig, Gregoire, Korthaus, Alexander, Frosch, Karl-Heinz, Krause, Matthias
Formato: research systematic review tables/charts Journal Article
Publicado: Springer Nature Apr2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2023
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-022-02127-2
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        atl: The value of magnetic resonance imaging in the preoperative diagnosis of tibial plateau fractures: a systematic literature review.
      aug:
        au:
          Thürig, Gregoire
          Korthaus, Alexander
          Frosch, Karl-Heinz
          Krause, Matthias
        affil: Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
      sug:
        subj:
          Magnetic Resonance Imaging Methods
          Tibial Plateau Fracture Diagnosis
          Soft Tissue Injuries Pathology
          Preoperative Care
          Injury Pattern
          Human
          Systematic Review
          PubMed
          Medline
          Cochrane Library
          Record Review
          Medial Collateral Ligament Sprain
          Collateral Ligaments
          Anterior Cruciate Ligament
          Posterior Cruciate Ligament
          Menisci, Tibial
          Comparative Studies
          Knee Radiography
          Funding Source
      ab: Purpose: The outcome of a tibial plateau fracture (TPF) depends on the fracture reduction achieved and the extent of soft-tissue lesions, including lesions in the ligaments, cartilage, and menisci. Sub-optimal treatment can result in poor knee function and osteoarthritis. Preoperative planning is primarily based on conventional X-ray and computed tomography (CT), which are unsuitable for diagnosing soft-tissue lesions. Magnetic resonance imaging (MRI) is not routinely performed. To date, no literature exists that clearly states the indications for preoperative MRI. This systematic review aimed to determine the frequency of soft-tissue lesions in TPFs, the association between fracture type and soft-tissue lesions, and the types of cases for which MRI is indicated. Methods: A systematic review of the literature was based on articles located in PubMed/MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL), supplemented by searching the included articles' reference lists and the ePublication lists of leading orthopedic and trauma journals. Results: A total of 1138 studies were retrieved. Of these, 18 met the eligibility criteria and included a total of 877 patients. The proportion of total soft-tissue lesions was 93.0%. The proportions of soft-tissue lesions were as follows: medial collateral ligament 20.7%, lateral collateral ligament 22.9%, anterior cruciate ligament 36.8%, posterior cruciate ligament 14.8%, lateral meniscus 48.9%, and medial meniscus 24.5%. A weak association was found between increasing frequency of LCL and ACL lesions and an increase in fracture type according to Schatzker's classification. No standard algorithm for MRI scans of TPFs was found. Conclusion: At least one ligament or meniscal lesion is present in 93.0% of TPF cases. More studies with higher levels of evidence are needed to find out in which particular cases MRI adds value. However, MRI is recommended, at least in young patients and cases of high-energy trauma.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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