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Segond fractures may be associated with anterolateral complex
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Results published in The American Journal of Sports Medicine revealed Segond fractures occur at the location of the tibial insertion of the anterolateral ligament, but distinct ligamentous attachments were unidentified by MRI.
Freddie H. Fu, MD, DSc(Hon), DPs(Hon), and colleagues reviewed MRI scans of 36 patients who had ACL injuries with Segond fractures to determine proximal-distal length, anterior-posterior width, medial-lateral width, proximal-distal distance to the lateral tibial plateau, anterior-posterior distance to the Gerdy tubercle and anterior-posterior distance from the Gerdy tubercle to the posterior aspect of the fibular head. Researchers categorized the attachment of the anterolateral structures to the Segond fragment as the iliotibial band or anterolateral capsule.
Plain radiographs showed a mean distance of the midpoint of the fracture to the lateral tibial plateau of approximately 4.6 mm, as well as a mean proximal-distal length and mean medial-lateral width of approximately 9.2 mm and 2.4 mm, respectively, of the avulsed fracture. Results showed the proximal fracture to the tibial plateau had a mean distance of approximately 3.4 mm on MRI. Researchers noted a mean proximal-distal length of approximately 8.7 mm, as well as a mean anterior-posterior width of approximately 11.1 mm. Between the Gerdy tubercle and the center of the fracture, researchers found a mean distance of approximately 26.9 mm. According to results, the Gerdy tubercle and the posterior fibular head had a mean distance of approximately 53.9 mm. The midpoint of the fracture to the tibial plateau had a mean distance of approximately 7.8 mm, while at 49.9% of the distance between the Gerdy tubercle and the posterior aspect of the fibular head was the center of the fracture.
According to an analysis of soft tissue structures attached to the fragment, 34 patients had the iliotibial band attached. Results showed the same number of patients had the capsule attached. In a literature review of 20 studies, researchers noted no differences between the previously described Segond fracture location and the tibial insertion of the anterolateral ligament
“This study contributes to our understanding of knee anatomy, confirming the findings of Dr. Paul Segond in 1879,” Fu told Healio.com/Orthopedics. “It aims to help surgeons avoid unnecessary procedures while providing cutting edge treatment for their patients.” – by Casey Tingle
Disclosures: The researchers report no relevant financial disclosures.
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