Document Detail


Hemi-bucket-handle tears of the meniscus: appearance on MRI and potential surgical implications.
MedLine Citation:
PMID:  22080362     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To describe a type of meniscus flap tear resembling a bucket-handle tear, named a "hemi-bucket-handle" tear; to compare its imaging features with those of a typical bucket-handle tear; and to discuss the potential therapeutic implications of distinguishing these two types of tears. MATERIALS AND METHODS: Five knee MR examinations were encountered with a type of meniscus tear consisting of a flap of tissue from the undersurface of the meniscus displaced toward the intercondylar notch. A retrospective analysis of 100 MR examinations prospectively interpreted as having bucket-handle type tears yielded 10 additional cases with this type of tear. Cases of hemi-bucket-handle tears were reviewed for tear location and orientation, appearance of the superior articular surface of the meniscus, presence and location of displaced meniscal tissue, and presence of several classic signs of bucket-handle tears. RESULTS: A total of 15/15 tears involved the medial meniscus, had tissue displaced toward the notch, and were mainly horizontal in orientation. The superior surface was intact in 11/15 (73.3%). In 1/15 (6.7%) there was an absent-bow-tie sign; 6/15 (40%) had a double-PCL sign; 14/15 (93.3%) had a double-anterior horn sign. CONCLUSION: We describe a type of undersurface flap tear, named a hemi-bucket-handle tear, which resembles a bucket-handle tear. Surgeons at our institution feel this tear would likely not heal if repaired given its predominantly horizontal orientation, and additionally speculate the tear could be overlooked at arthroscopy. Thus, we feel it is important to distinguish this type of tear from the typical bucket-handle tear.
Authors:
Bjorn I Engstrom; Emily N Vinson; Dean C Taylor; William E Garrett; Clyde A Helms
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-12
Journal Detail:
Title:  Skeletal radiology     Volume:  -     ISSN:  1432-2161     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7701953     Medline TA:  Skeletal Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC, 27710, USA, bjorn.engstrom@duke.edu.
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