Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jun 18, 2017; 8(6): 484-490
Published online Jun 18, 2017. doi: 10.5312/wjo.v8.i6.484
Medial tibial plateau morphology and stress fracture location: A magnetic resonance imaging study
Kiminori Yukata, Issei Yamanaka, Yuzuru Ueda, Sho Nakai, Hiroyoshi Ogasa, Yosuke Oishi, Jun-ichi Hamawaki
Kiminori Yukata, Issei Yamanaka, Yuzuru Ueda, Sho Nakai, Yosuke Oishi, Jun-ichi Hamawaki, Department of Orthopedics, Hamawaki Orthopaedic Hospital, Hiroshima 730-0051, Japan
Kiminori Yukata, Hiroyoshi Ogasa, Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi 755-8505, Japan
Author contributions: All the authors contributed to this manuscript.
Institutional review board statement: This investigation has been approved by the Ethics Committee of the Hamawaki orthopaedic Hospital.
Informed consent statement: The study protocol was approved by the institutional review board, and the requirement for informed consent was waived.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kiminori Yukata, MD, PhD, Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. yukata@ogoridaiichi.jp
Telephone: +81-83-6222268 Fax: +81-83-6222267
Received: October 20, 2016
Peer-review started: October 23, 2016
First decision: December 20, 2016
Revised: January 6, 2017
Accepted: May 18, 2017
Article in press: May 19, 2017
Published online: June 18, 2017
Abstract
AIM

To determine the location of medial tibial plateau stress fractures and its relationship with tibial plateau morphology using magnetic resonance imaging (MRI).

METHODS

A retrospective review of patients with a diagnosis of stress fracture of the medial tibial plateau was performed for a 5-year period. Fourteen patients [three female and 11 male, with an average age of 36.4 years (range, 15-50 years)], who underwent knee MRI, were included. The appearance of the tibial plateau stress fracture and the geometry of the tibial plateau were reviewed and measured on MRI.

RESULTS

Thirteen of 14 stress fractures were linear, and one of them stellated on MRI images. The location of fractures was classified into three types. Three fractures were located anteromedially (AM type), six posteromedially (PM type), and five posteriorly (P type) at the medial tibial plateau. In addition, tibial posterior slope at the medial tibial plateau tended to be larger when the fracture was located more posteriorly on MRI.

CONCLUSION

We found that MRI showed three different localizations of medial tibial plateau stress fractures, which were associated with tibial posterior slope at the medial tibial plateau.

Keywords: Magnetic resonance imaging, Runner, Stress fracture, Tibial plateau, Tibial posterior slope

Core tip: Stress fracture of the medial tibial plateau is a rare injury. No studies have investigated detailed magnetic resonance imaging features of this fracture type. We found three distinct location types of isolated stress fractures of the medial tibial plateau. Posterior tibial slope serves as an indicator to determine the fracture site at the medial tibial plateau.