Computed tomography in diagnosis of posterior column fracture of tibial plateau

Abstract

Objective To Study the incidence and epidemiological feature of posterior column fractures of tibial plateau which are examined by computed tomography (CT) and three-dimensional computed tomography (3D-CT) reconstruction. Methods From July 2004 to July 2007, 202 cases of tibial plateau fractures were examined preoperatively by X-ray, CT and 3D-CT. Based on their CT images, the tibia] plateau was divided into 3 regions (columns) . The fractures were classified accordingly. The incidence of posterior column fractures was calculated, compared with the results of X-ray classification and the discoveries in op-eration. The value of CT and 3D-CT in diagnosis and treatment of tihial plateau fractures were assessed. Results In 21 cases, X-ray and CT showed different results. Of them, 5 tibial plateau fractures were not found on X-ray films hut on CT scans, and the classification for the other 16 fractures was wrong. CT showed there were 47 posterior column fractures of tibial plateau, the incidence being 23.2%. The classification a-greement between X-ray and CT was 89.6%. Conclusions 3D-CT reconstruction can visualize tibial plateau fractures from different views, which provides great advantage for fracture classification. CT scans can make clear diagnosis of posterior column fractures of tibia] plateau which are not rare. Key words: Tibial fracture; Diagnosis; Treatment; CT; Posterior column fracture