P.Y.YEO1, V. VIVEGAN2, M.J.A.SEAH3, T.J.L.TAN4, T.JEGATHESAN4, K.T.LEE4, W.L.S.HO4
Khoo Teck Puat Hospital1, National Neuroscience Institute2, Singapore Armed Forces3, Tan Tock Seng Hospital4
The Segond fracture is a small vertical avulsion fracture of the lateral tibial plateau that is widely regarded as pathognomonic of anterior cruciate ligament (ACL) rupture. This study aims to establish the incidence of associated ligamentous and meniscal injuries in patients with ACL rupture and Segond fractures.
A retrospective review of all consecutive patients who underwent ACL reconstruction for ACL rupture in a single tertiary hospital between 2011 to 2018 was conducted.
A total of 553 subjects were included in the study. 18.6% (103) were female and 81.4% (450) were male. The overall incidence of Segond fracture was 2.2%. Among the patients with Segond fracture, 8.3% (1), 16.7% (2), 50% (6) and 25% (3) of subjects had concomitant MCL, medial meniscus, lateral meniscus injuries and bone marrow edema respectively. There was a higher incidence of associated MCL (8.3% vs 7.6%) and lateral meniscus (50% vs 41.2%), and a lower incidence of associated PCL (2.4% vs 0%), LCL (3.9% vs 0%) and medial meniscus (52.1% vs 16.7%) as well as bone marrow edema (36.4% vs 25%) in patients with Segond fracture compared to those without.
The incidence of associated ligamentous and meniscal injuries is not significantly different in the presence of a Segond fracture, suggesting that the presence of a Segond fracture is not necessarily indicative of a higher energy and/or velocity in terms of the mechanism of injury.