Usefulness of MRI in Distal Femoral Intra-articular Fracture

Kim, Hyung Chun; Kim, Kwang Ryul; Lim, Moon Sup; Lee, Seong Joo; Lee, Do Young

Abstract

PURPOSE: Preoperative recognition of an associated injuries including ligament disruptions of the knee and Hoffa fracture in the cases of the intra-articular distal femoral fractures affects surgical planning. The purpose of this study is to identify the usefulness of MRI in distal femoral intraarticular fracture. MATERIALS AND METHODS: Over a 7 years period from January 1995 to December 2001, all patients with an intra-articular fracture of the distal femur were collected from a prospectively designed orthopaedic database and reviewed. Seventy five patients with intra-articular distal femoral fractures were collected. There were 49 male and 26 female patients ranging from 15 to 91 in age. Because these injuries usually result from high-energy trauma, we should also exclude associated injuries of pelvis, hip, patella, tibial plateau fractures, popliteal vessel injuries, and ligament disruptions of the knee. So we checked knee MRI of patients with distal femoral fractures to rule out associated knee injuries. RESULTS: There were 12 Hoffa's fractures, 6 anterior cruciate ligament injuries, 6 posterior cruciate ligament injuries, 10 medial collateral ligament injuries and 3 lateral collateral ligament injuries. Five patients of 12 Hoffa's fractures associated with intra-articular distal femoral fractures that were not diagnosed in patients with conventional radiographs were confirmed after MRI evaluation. CONCLUSION: Knee MRI for intra-articular distal femoral fracture is necessary to rule out associated ligament injuries and Hoffa fractures in case of high-energy trauma patients.