Jonathan D Gillig1, Russell D Goode2, Brian Campfield3, Julia R Crim4, Brett D Crist5. 1. Department of Orthopaedic Surgery, University of South Alabama School of Medicine, Mobile, AL. 2. The Orthopaedic Group, P.C., Mobile, AL. 3. Department of Orthopaedic Surgery, Geisinger, Danville, PA. 4. Department of Radiology, University of Missouri, Columbia, MO. 5. Department of Orthopaedic Surgery, University of Missouri, Columbia, MO.
Abstract
OBJECTIVES: To address the safety of obtaining magnetic resonance imaging (MRI) in patients with temporary knee-spanning external fixators placed for tibial plateau fractures. DESIGN: Institutional Review Board-approved retrospective review. SETTING: Level 1 trauma center. PATIENTS/PARTICIPANTS: Records were reviewed on patients with knee-spanning external fixators applied during staged management of tibial plateau fractures from 2009 to 2015 and who also had an MRI performed. MAIN OUTCOME MEASUREMENTS: Complications associated with the MRI; secondary outcomes were pain scores, narcotic requirements, and fracture healing. RESULTS: A total of 56 patients with 57 fractures were included, and 55 scans (96.5%) were completed without complication. Two scans (3.5%) were stopped prematurely for patient-reported pain and subjective warmth of the external fixator. For all 57 studies, pain scores and narcotic usage were unchanged, and all fractures healed without complication. CONCLUSIONS: Knee-spanning external fixator placement does not preclude MRI for patients with tibial plateau fractures. MRIs can be safely performed on patients with external fixators if patients are educated before imaging. Even in the small percentage of patients who experienced discomfort, there were no long-term complications. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
OBJECTIVES: To address the safety of obtaining magnetic resonance imaging (MRI) in patients with temporary knee-spanning external fixators placed for tibial plateau fractures. DESIGN: Institutional Review Board-approved retrospective review. SETTING: Level 1 trauma center. PATIENTS/PARTICIPANTS: Records were reviewed on patients with knee-spanning external fixators applied during staged management of tibial plateau fractures from 2009 to 2015 and who also had an MRI performed. MAIN OUTCOME MEASUREMENTS: Complications associated with the MRI; secondary outcomes were pain scores, narcotic requirements, and fracture healing. RESULTS: A total of 56 patients with 57 fractures were included, and 55 scans (96.5%) were completed without complication. Two scans (3.5%) were stopped prematurely for patient-reported pain and subjective warmth of the external fixator. For all 57 studies, pain scores and narcotic usage were unchanged, and all fractures healed without complication. CONCLUSIONS: Knee-spanning external fixator placement does not preclude MRI for patients with tibial plateau fractures. MRIs can be safely performed on patients with external fixators if patients are educated before imaging. Even in the small percentage of patients who experienced discomfort, there were no long-term complications. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.