Magnetic resonance imaging in the evaluation of tibial eminence fractures in adults.

Abstract

Proton density and T2-weighted sagittal, axial, coronal, and inversion recovery fat suppression magnetic resonance imaging (MRI) sequences were reviewed in 21 adults (10 men and 11 women) with 22 tibial eminence fractures. Average patient age was 43 years (range: 19-62 years). There were 3 type I, 3 type II, 12 type III, and 4 type IV fractures. The average fracture fragment size was 21 x 23 mm, and the average displacement was 5.5 mm (range: 0-12 mm). The MRI disclosed anterior cruciate ligament (ACL) insertional avulsions in 20 (91%), distal posterior cruciate ligament (PCL) avulsions in 4 (18%), intrasubstance ACL damage in 9 (41%), intrasubstance PCL injury in 3 (14%), medial collateral ligament (MCL) tears in 9 (41%) knees, retinacular injury in 8 (36%), posterolateral corner damage in 8 (36%), medial meniscal tears in 5 (23%), and 4 (18%) had lateral meniscal tears. Occult subchondral osseous injuries were seen in the posterolateral tibial plateau in 13 (59%) knees, anterolateral femoral condyle in 4 (18%), and posteromedial tibial plateau in 5 (23%) knees. Discrete osteochondral fractures were present in 7 (32%) knees. Significant osseous, cartilaginous, meniscal, and ligamentous damage was discovered in all patients. Based on these findings, we recommend MRI evaluation of all tibial eminence fractures to accurately detect all knee damage.