MR imaging in tibial shaft fractures - A potential method for early visualization of delayed union

Purpose: To evaluate the relationship between MR findings at the fracture s ite during the healing process and the outcome of patients with tibial shaf t fracture. Material and Methods: Twelve consecutive patients with an uncomplicated tib ial fracture treated conservatively were imaged by MR 1 to 3 days, 1 week, 3 weeks, 6 weeks and 12 weeks after the trauma. MR imaging consisted of sag ittal/coronal T1-weighted, T2-weighted, proton density, short-tau inversion recovery, and contrast-enhanced T1-weighted spin-echo images. The images w ere analysed for the extent of signal pathology in the bone marrow adjacent to the fracture, the extent of soft tissue oedema, and the intensity and h omogeneity of the contrast enhancement of the callus. Results: The differences between normal(n=7) and delayed union (n=5) were o bserved within 3 to 6 weeks after the trauma, mainly in the homogeneity of the callus in T2-weighted and contrast-enhanced images. Conclusion: MR imaging is a potentially valuable method for early visualiza tion of delayed union in tibial shaft fractures.