Reverse segond fracture is originally described as an indirect radiographic clue for a. Incidence and prognostic significance of the segond fracture. By om albtoush 201 cited by 8 the segond fracture is a tibial avulsion injury of the insertion of the middle third of the lateral capsular ligament that is typically associated with anterior cruciate. Segond fracture with anterior cruciate ligament tear in an adolescent. Pdf segond fracture after anterior cruciate ligament. Reverse segond fracture without posterior cruciate ligament. Avulsion fractures of the knee rsna publications online. Esta pequena fratura está associada a lesões multiligamentares, principalmente do. By b sonnerycottet cited by 3 the segond fracture sf is considered pathognomonic of an anterior cruciate ligament. , segond fracture on radiography, a concomitant rupture of the anterior cruciate ligament acl was. Ap knee xray shows a curvilinear or elliptical bone fragment parallel to the lateral aspect of the tibial plateau the lateral capsular sign. By os kwon 2011 cited by 8 marginal fractures of the medial tibial plateau have been reported in the literature as a secondary type of segond fracture. By j porrino cited by 17 associations between ligament tears and tibial plateau fracture location medial vs lateral.
Segond fracture with the presence of significant knee instability was demonstrated in 17 by woods. Anterior cruciate ligament reconstruction by melugin et al. Segond fracture after anterior cruciate ligament reconstruction. Is treatment of segond fracture necessary with combined. To investigate the relationship between the segond fracture and the anterolateral complex of the knee. It is considered highly suggestive of anterior cruciate ligament acl lesion in the adult population.
The purpose of this study was to investigate the relation of the segond fracture with the anterolateral ligament all of the knee. Commonly discussed avulsion fractures of the lateral knee include the segond fracture of the lateral tibial plateau and the arcuate complex avulsion fracture of the fibular styloid process. Segond fracture in an adult is not pathognomonic for acl. A segond fracture is an avulsion of the laterial ubial rim cortex secondary to avulsion of the lateral capsular ligament.
By ab goldman 188 cited by 244 in our series, the segond fracture was uniformly associated with detachment of the capsular portion of the lateral collateral ligament and tears of the anterior. By jb de alencar neto cited by 1 radiographs of the knees showed a segond fracture associated with the arched signal bilaterally. A case of anterior cruciate ligament disruption in a patient with an avulsion. By wn weber 11 cited by 131 bone marrow adjacent to the fracture emitted a focally ab normal. A finite element analysis of relationship between fracture. Hess et al 14 found that of 151 patients with acl lesions, % had segond fractures, whereas control group there was may 01, 2001. There is a paucity of clinical information to guide the treatment of a combined anterior cruciate ligament acl tear and segond fracture. A unique variant of reverse segond fracture international. Suspected acl and pcl injuries full thickness midsubstance acl rupture and partial thickness tearing of the anterolateral bundle of the tibial attachment of the pcl confirmed on mri 12211. All orthopedic residents learn that this is pathognomonic for diagnosis.
By kp valkering 200 cited by 6 segond tibial condyle fracture. Segond fractures and segond fractures associated with a tibial plateau fracture. Comminuted fractures of the proximal fibula with minimal displacement. Pdf the segond fracture is a small vertical avulsion injury of the lateral aspect of the proximal tibia just distal to the plateau. Segond fracture is a rare lesion in adolescents, resulting from rotational forces in the knee. Avulsion fracture of the medial collateral ligament association. When this type of injury is diagnosed, the radiologist should consider posterior cruciate ligament injury and peripheral medial meniscal tears as possible associated. On followup radiographic examination, seven patients demonstrated a characteristic bone excrescence.
Segond fracture associated with avulsion of both anterior. Segond fracture revealed by ultrasonography wiley online. Additionally, when a segond or reverse segond fracture fragment. Avulsion fracture at the tibial insertion of the deep component of the medial collateral ligament is a rare. Segond fracture wikimili, the best wikipedia reader. Pdf the authors report a case of a 1yearold man with a segond fracture with knee effusion after an acute injury, in addition to findings of prior. A frontal radiograph of the knee demonstrates an avulsio. Unlike the segond, which is often seen with sporting injury, the reverse segond appears to occur with higher velocity injuries, such as being struck by a motor vehicle 2, and may be associated with knee dislocation.
The segond fracture is an avulsion of the anterolateral tibia that can be found in patients with an anterior cruciate ligament acl. Segond fracture, hemarthrosis, and anterior cruciate ligament. By e monaco 2017 cited by 8 segonds fracture is a wellrecognised radiological sign of an anterior cruciate ligament acl tear. By n boutry 2005 cited by 12 the knee and therefore produce an avulsion fracture of the lateral tibial plateau. Segond fracture is an avulsion fracture of the knee that involves the lateral aspect of the tibial plateau and is very frequently 75% of cases associated with disruption of the anterior cruciate ligament acl. Is the segonds fracture a reliable sign of anterior.
Segond fractures are not a risk factor for anterior cruciate ligament reconstruction failure 26 september 2017 the american journal of sports medicine, vol. In four acute cases with a positive lateral capsular sign on xray, a concomitant rupture of the anterior cruciate ligament acl was demonstrated. Because of the high rate of associated ligamentous and meniscal. Avulsion fracture of the medial tibial plateau reverse segond.
Système darthroplastie de lépaule epoca fractures technique opératoire depuy synthes 11 percer deux trous dans le tubercule majeur avec une mèche. We describe the case of a 27yearold woman who was hit by a car and suffered polytrauma, mainly suffering injuries to both knees. This is a case of a 13 year old girl who presented with sudden onset knee pain while playing soccer. He studied medicine in paris, becoming an intern in 1875, having already published a letter on weight of newborns in the annales de gynécologie. Acl tear is diagnosed and likely represents an avulsion of the anterolateral ligament. The anterolateral ligament orlando orthopaedic center. Reverse segond fracture variant without posterior cruciate. A 16yearold football athlete with a segond fracture. 14 the segond fracture is an avulsion of the anterolateral complex. The reverse segond fracture represents cortical avulsion caused by a tug. Demonstrate an isolated segond fracture coursing with anterolateral knee instability without acl neither other knee ligament injuries in.
By ss arneja 2010 cited by 13 paul segond, the segond fracture is now widely accepted as a pathognemonic radiographic marker of anterior cruciate ligament injury. On the frontal knee radiograph, it may be referred to as the lateral capsular sign. Winter wipeout american college of emergency physicians. Segond fracture was analyzed for its specific location, size, displacement, and healing using both radiographic images and mri. The aim of this study was to evaluate the effect of a.
By r wharton 2015 cited by 15 the segond fracture is an avulsion fracture of the lateral tibial plateau and is considered pathognomonic for anterior cruciate ligament acl. There are few cases of segond fractures in adolescent in literature. The segond fracture is a small vertical avulsion injury of the lateral aspect of the proximal tibia immediately distal to the tibial plateau. The segond fracture is a type of avulsion fracture soft tissue structures tearing off bits of their bony attachment of the lateral tibial condyle of the knee, immediately beyond the surface which articulates with the femur contents. A anteroposterior radiograph of the left knee shows an elliptic bone fragment arrow arising from the lateral tibial plateau the lateral capsular.
Figure a3 healing of identified segond fractures figure a1 segond fracture on coronal radiograph figure a2 healed segond coronal radiograph nonhealing healing response pvalue months from injury to surgery 4. A plain radiograph revealed a segond fracture and a subsequent mri confirmed a complete anterior cruciate ligament rupture. By o kose 2016 cited by 7 posterior cruciate ligament avulsion fracture. Segond fractures involve the anterolateral knee capsule but. While previous studies evaluated the role of the anterolateral ligament all and complex injuries on rotational stability of the knee, there are no studies on the biomechanical effect of segonds fracture in an acl deficient knee. The segond fracture is a type of avulsion fracture from the lateral tibial plateau of the knee. Elle peut également saccompagner dune lésion des structures. Avulsion fracture of the iliotibial band and anterolateral ligament is known as a segond fracture, and it is another rare entity. Avulsion fractures around the knee and their importance. This report, together with the work of goldman and hess, has founded the current belief of. En cas de fracture significative de la glène ou du bourrelet glénoïdien.
By a hardy 200 cited by 1 avulsion fracture involving the proximal tibia just distal to the lateral plateau, known as a segond fracture, was de scribed in cadaver experiments by paul. Segond fractures of the lateral tibial condyle bone & joint. By ds davis 17 cited by 54 n 187, paul segond, using cadaveric knees, demonstrated that excessive tibial internal rotation with the knee flexed produced an avulsion fracture of the lateral. Fibular head avulsion fractures are rare and are socalled the arcuate signal. By hd kerr 10 cited by 16 this paper is only available as a pdf. The reverse segond fracture is thought to result following external rotation of the knee, with applied valgus stress 1 c.
Segond fracture is one of the most com monly encountered avulsion fractures of the knee joint, which was classically. A juxtaarticular segond or pseudosegond fracture is indicative of a capsular. By e cavaignac cited by we read the article entitled is treatment of segond fracture necessary with combined. Segonds fracture is a wellrecognised radiological sign of an anterior cruciate ligament acl tear. Slagstad segond fractures in acl reconstruction am j med. Described an avulsion fracture at the anterolateral proximal tibiathe segond fracture. By sk marupaka we had cases of acl, pcl, mcl medial collateral ligament avulsions, segond and arcuate fractures in addition to a patellar sleeve avulsion. Purpose the purpose of this study was to investigate the relation of the segond fracture with the anterolateral ligament all of the knee.
Segond fracture in an adult is not pathognomonic for acl injury. Slagstad et al segond fractures in acl reconstruction am j sports med appendix. The segond fracture or lateral capsular sign is an avulsion fragment of the lateral tibial plateau, which corresponds to the distal insertion point of the lateral capsular ligament or lateral meniscotibial ligament. Segond fracture journal of the american college of surgeons. Surgical treatment for avulsion fractures of the anterolateral.
However, this band was not routinely discussed, identi ed, and con rmed during. He became prosector at the faculté de médecine de paris of the university of paris in 1878. A small avulsed bone fragment, elliptical in shape, lying immediately below the external. Segond fractures involve the anterolateral knee capsule. Reported 23 tpf with segond fractures, of which 17.
Reverse segond fracture is a cortical avulsion fracture off the medial tibial plateau of the knee, associated with tears of the posterior cruciate. To compare clinical outcomes, graft failure rates, and activity levels between patients undergoing acl reconstruction aclr with and without an untreated segond fracture at a minimum 2year followup. Capsular sign and then named segond fracture an avulsion fracture of the midportion. We found that 71% of the paplateau fracture fracture tibial plateau fracture. Mr signal, which indicated an injury of the lateral capsular junc tion. Reverse segond fracture radiology reference article.
The segond fracture is considered highly suggestive of an anterior cruciate ligament acl tear in the. To identify the softtissue structure causative for the segond fracture, a study was set up to compare anatomic details of the tibial insertion of the recently characterized all in cadaveric knees n 30 with radiologic data obtained from. Osseous injury associated with ligamentous tear of the. By s claes 2014 cited by 1 in 4 acute cases with a positive lateral capsular sign i. The segond fracture is usually diagnosed on anteroposterior radiographs. Bilateral avulsion fracture of the fibula head of the knee. Article text in portuguese english pdf portuguese pdf article in xml format how to cite this article scielo analytics curriculum scienti automatic translation.
By j ringenberg 2015 cited by 2 sign, or segond fracture on radiography. A capsular injury on either the medial or lateral side may exist in conjunction with a flake fracture near the joint surface, and this is referred to as the segond or pseudosegond fracture. Observations on rotatory instability of the lateral compartment of the knee. A segond fracture is associated with acl rupture in 75100% of cases and with menis cal injury in 4267% of cases 13. Statistical analysis was performed using a p value of dec 01, 2010. Our findings are in agreement with those of previous studies. It is frequently a varus stress that leads to a lateral collateral complex injury. Paul segond was born in paris, the son of anatomist louisauguste segond 181108. Region on the proximal tibia from where segond fractures consistently avulse, thus suggesting that the. Segond fractures may be identified when an anterior cruciate ligament. A less common avulsion fracture is the iliotibial it band avulsion fracture involving the anterolateral corner of the tibia gerdys tubercle. We present a case of a segond fracture with parcial acl lesion, in an adolescent.
By gb irvine 187 cited by 7 jakob rp, hassler h, staeubli hu. Segond fracture combined with tibial plateau fracture. A segond fracture is an avulsion fracture the lateral aspect of the tibial plateau. By r wharton 2015 cited by 14 the segond fracture is an avulsion fracture of the lateral tibial plateau and is considered. Reverse segond fracture and associated knee injuries acta. By x wei 2020 aspect of the human knee attached to an eponymous segond fracture 5, 30. By js virk 2016 cited by 1 the typical segond fracture includes a triad of avulsion fracture of the lateral tibial plateau with anterior cruciate ligament tear 75 100% of cases and lateral. Saudações a todos neste vídeo vamos conversar sobra a fratura de segond.
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