Thirty patients with 31 tibial plateau fractures, initially diagnosed
with standard radiography, were further studied with biplane linear to
mography and magnetic resonance (MR) imaging. Each fracture was catego
rized according to the Schatzker classification. The extent of comminu
tion and articular depression was determined for each modality. MR ima
ges were also evaluated for the presence of accompanying meniscal and
ligamentous injury. In each case, MR imaging was noted to be as effect
ive as tomography in depicting the amount of articular depression. MR
imaging was found to be more effective than tomography in determining
the extent of comminution. Beyond demonstrating the fracture, MR imagi
ng was capable of revealing associated ligamentous and meniscal injuri
es. There was an increased prevalence of accompanying soft-tissue inju
ries in those fracture types that are associated with more violent for
ces and as the extent of articular depression increased. MR imaging is
a useful and effective means of preoperatively evaluating tibial plat
eau fractures.