Internal derangement of the knee after ipsilateral femoral shaft fracture: MR imaging findings |
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Authors: | M F Blacksin John V Zurlo Andrew S Levy |
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Institution: | (1) Department of Radiology, University of Medicine & Dentistry of New Jersey, C320, University Hospital, 150 Bergen Street, Newark, NJ 07103–2426, USA, US;(2) Department of Orthopedic Surgery, University of Medicine and Dentistry of New Jersey, University Hospital, Newark, NJ 07103–2426, USA, US |
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Abstract: | Objective. This study uses magnetic resonance (MR) imaging to delineate the types and frequencies of injuries seen in the knee after
ipsilateral femoral shaft fracture. We also compare the results of the orthopedic knee examination with the MR findings. Design and patients. MR imaging of the ipsilateral knee was performed on 34 patients with closed femoral shaft fractures. Indications for knee
MR imaging included knee pain at the time of fracture, soft tissue swelling or an effusion of the knee, or a positive knee
examination under anesthesia. The patients had a mean age of 27 years and all were stabilized with intramedullary nails. Imaging
was performed a mean time of 2.5 days after surgery. All patients had knee examinations done under anesthesia, and the MR
results were compiled and compared with the clinical examinations. Results. Ninety-seven percent of patients demonstrated knee effusions. Twenty-seven percent of patients demonstrated meniscal tears,
with the posterior horn of the medial meniscus most frequently torn. The medial collateral ligament was the most frequent
site of ligamentous injury (38%) followed by the posterior cruciate ligament (21%). Fifty percent of patients had injuries
of the extensor mechanism. Bone bruises were noted in 32% of patients. Articular cartilage injuries were confined to the patella
in four cases. One occult tibial plateau fracture and one meniscocapsular separation were seen. Conclusions. There is a common incidence of both ligamentous and meniscal injury to the knee after ipsilateral femoral shaft fracture.
MR imaging can be useful in assessing the extent of injury, and may reveal findings unsuspected after clinical examination
of the knee. |
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Keywords: | Femur fracture Knee injury MR imaging of the knee |
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