To demonstrate the frequency of soft tissue injuries associated with tibial plateau fracture and analyze the pattern of fracture more accurately by magnetic resonance imaging (MRI).

The plain films and MRI of 27 patients with acute tibial plateau fracture were analyzed. Every fracture was classified by findings on plain film and MRI respectively according to the Schatzker system and they were compared with each other. The degree of displacement and depression of the fracture fragments were measured on plain film and MRI.

MRI was more accurate in determining the classification of the fracture and in measuring the displacement and depression of fragments. Fracture types of 2 cases classified by the findings of plain film were changed to different types by MRI findings. Evidence of internal derangement of the knee was found in 26(96.3%) patients. Anterior cruciate ligament injuries were seen in 12(44.4%) patients and posterior cruciate ligament injuries in 10(37.0%) patients. Medial collateral ligament injuries were seen in 11(40.7%) patients and lateral collateral ligament injuries in 8(29.6%) patients. Medial and lateral meniscus tears were seen in 8(29.6%) patients respectively.

Most of the patients with acute tibial plateau fracture were commonly associated with ligamentous and meniscal injuries. MRI can aid in accurate evaluation of tibial plateau fracture patterns and decision of treatment plan.