Role of Multi Detector Computed Tomography with 3D Reformation versus Plain Radiography in the Evaluation and Classification of Posterior Column Involvement in Tibial Plateau Fractures

Anuja Saikia, Sahnaz Rahman, Preetish Kolaki, Changhom Thoumoung, Rudra Kanta Gogoi

Abstract: Objective: The purpose of our study is to determine the role of3 - Dimensional Computed Tomography in the evaluation of posterior column involvement intibial plateau fractures of the knee for preoperative evaluation and surgical planning by using Three - column and Schatzker?s classification systems. Materials and Methods: Fifty patients of knee trauma underwent Plain Radiography and CT with 3 - Dimensional reconstruction. The characterization and type of fractures were evaluated in all the cases. Results: In our study, 50 tibial plateau fractures were examined with plain films and MDCT with 3D reformation. The posterior column involvement was underestimated in 11 cases in Plain Radiography while MDCT accurately detected the fracture pattern in all the cases. Schatzker?s classification system had the drawback of not including posterior column involvement. Conclusion: MDCT with 3D reformation proved to be superior to Plain Radiography in complete depiction of the fracture pattern, which led to preoperative modifications that prevented dreadful post - operative complications. The three - column classification seemed to be an effective way to characterise and classify fractures of the tibial plateau.

Keywords: Tibial plateau, Three - column classification, Schatzker?s classification, Plain Radiography, Multidetector Computed Tomography