| Print Date: | May 25, 2013, 12:41 pm |
| Title | 1. Mid-substance ACL tear.
2. Lateral capsular avulsion consistent with Segond fracture |
| Text | A Segond fracture is a cortical avulsion of the tibia at the site of insertion of the lateral capsular ligament. This fracture results from excessive internal rotation and varus stress of the knee. Segond fractures are frequently associated with other internal knee derangements including ACL tear (75-100%), meniscal tears - particularly medial meniscus (66-75%), and other avulsion fractures of the fibular head or intercondylar eminence. Therefore, a patient with a Segond fracture, which is usually best seen on A/P radiographs, should be further evaluated by MRI for anterior cruciate ligament and other associated bone, ligamentous, and meniscal injuries. Sagittal T2W MRI with fat saturation is 95% sensitive and 98% specific for showing ACL tears. Treatment for Segond fracture is generally conservative for non-displaced/non-inverted fractures. Treatment for ACL tear is surgical for the athletic individual who wishes to return to his or her level of activity. Best results are usually achieved with a patellar tendon autograft. |
| References: | 1. Hess T, Rupp S, Hopf T, Gleitz M, Leibler J. Lateral tibial avulsion fracture and disruptions to the anterior cruciate ligament. A clinical study of their incidence and correlation. Orthopadische Universitatsklinik Homburg/Saar, Germany. Clin Orthop 1994; 303:193-197.·
2. Kaplan PA, Musculoskeletal MRI, 1st ed. W.B. Saunders: Philadelphia, P. 376-378. 3. Murphy BJ, Smith RL, Uribe JW, et al. Bone signal abnormalities in the posterolateral tibia and lateral femoral condyle in complete tears of the anterior cruciate ligament: a specific sign? Radiology. 1992 Jan:182:221-4. |
| Contributor | MS-4 USU Teaching File (Uniformed Services University) |
| Author | Joshua Packard |
| Peer Reviewer | Lorraine G. Shapeero, M.D. (Uniformed Services University) |
| Record Number | : 5533 |
| Created | 2004-03-04 23:02:19-05 |
| Modified | 2009-06-11 13:26:32.733787-04 |
| Category: | Trauma |
| Location: | MSK - Musculoskeletal |
| Sublocation: | Knee |
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