MRI for diagnosis of fracture of the distal tibia

The rare transitional fractures occur in adolescents at a time of incomplet e desis of the epiphysis. The anatomy of this fracture type is complex with the fracture line running in multiple planes. Conventional plain film radi ographs often underestimate the extent and geometry of the fracture due to its transverse components. This study was performed to asses the benefit of M R-imaging compared to pl ain film radiographs in diagnosis and analysis regarding fracture-type, ana tomy and dislocation of fracture. During a time period of 18 months we treated 15 patients with a fracture of the distal tibial epiphysis. In addition to plain film radiographs they go t MRI of the distal tibia. Plain film radiographs and MRI were anonymized a nd diagnosed by 2 surgeons and 2 radiologists. 12 transitional fractures were diagnosed in plain radiographs as well as MR I, but regarding our criteria as above, we found two wrong classifications of fracture-type, an underestimation of fracture dislocation of an average of 0,5 mm in plain film radiographs and two rotational dislocations were mi ssed. The MRI was found to provide anatomical detail and information superior to plain film radiographs.