Segond fracture
From Wikipedia, the free encyclopedia
| Segond fracture | |
|---|---|
 | |
| Segond fracture of left knee | |
| Specialty | Orthopedic |
The Segond fracture is a type of avulsion fracture (soft tissue structures pulling off fragments of their bony attachment) from the lateral tibial plateau of the knee, immediately below the articular surface of the tibia (see photo).
Because of the high rate of associated ligamentous and meniscal injury, the presence of a Segond or reverse Segond fracture requires that these other pathologies must be specifically ruled out. Or more pragmatically, the orthopaedic team assume that the presence of Segond fracture equals ACL rupture, as the correlation is close to 100%. Increasingly, reconstruction of the ACL is combined with reconstruction of the anterolateral ligament when this associated pathology is present.[1][2][3][4] The long-term benefit of an associated Anterolateral Ligament (ALL) reconstruction at the time of ACL surgery is not known. Attention and research is also being paid to a Lateral extra-articular Tenodesis (LET) instead of ALL.[citation needed]
Diagnosis
Segond and reverse Segond fractures are characterized by a small avulsion,[5] or "chip", fragment of characteristic size that is best seen on plain radiography in the anterior-posterior plane. The avulsed fragment of bone may be very difficult to see on the plain x-ray exam, and may be better seen on computed tomography. MRI may be useful for visualization of the associated bone marrow edema of the underlying tibial plateau on fat-saturated T2W and STIR images, as well as the associated findings of ligamentous and/or meniscal injury.[citation needed]