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. 2020 Apr;48(5):1063-1068.
doi: 10.1177/0363546520905557. Epub 2020 Mar 2.

Incidence and Prognostic Significance of the Segond Fracture in Patients Undergoing Anterior Cruciate Ligament Reconstruction

Irene Slagstad  1 , Anagha P Parkar  2   3 , Torbjørn Strand  4 , Eivind Inderhaug  3   4   5
Affiliations

Incidence and Prognostic Significance of the Segond Fracture in Patients Undergoing Anterior Cruciate Ligament Reconstruction

Irene Slagstad et al. Am J Sports Med. 2020 Apr.

Abstract

Background: The Segond fracture is an avulsion of the anterolateral tibia that can be found in patients with an anterior cruciate ligament (ACL) tear. It is currently unclear if the Segond fracture needs treatment or if it heals spontaneously and if it is associated with an increased risk of failure after ACL reconstruction.

Purpose: To identify the incidence and spontaneous healing rate of Segond fractures in a consecutive cohort of patients undergoing ACL reconstruction and to examine the predictive value of the Segond fracture on the risk of undergoing revision surgery.

Study design: Cohort study; Level of evidence, 3.

Methods: A retrospective review of a cohort undergoing isolated ACL reconstruction between 2002 and 2016 was performed. Radiographs from the time of injury and preoperative radiographs were evaluated for Segond fractures and healed Segond fractures. Descriptive data were extracted from an internal quality database. Statistical analyses were performed to investigate risk of revision surgery and to compare across subgroups of patients.

Results: A total of 1364 patients were included in the study. The incidence of Segond fractures was 7.4%. In addition, 10.4% of patients displayed signs of healed Segond fractures. In total, 15.2% of patients had either 1 or both findings. The overall healing response of the fracture was 35.6%. Those with Segond fractures were older (P = .014) and had a shorter interval from injury to surgery (P = .003) as compared with the rest of the cohort. The incidence of Segond fractures was significantly higher in those injured during downhill skiing as compared with other injury mechanisms (P = .04). The Segond fracture did not represent an increased risk of undergoing revision when compared with the control group (not significant).

Conclusion: The incidence of conventional Segond fractures in patients with ACL injury was found to be in accordance with former studies. Accounting for the high incidence of healed Segond fractures, a much higher incidence (15%) was seen. Although the spontaneous healing rate from initial radiographs to preoperative imaging was only 36%, the presence of Segond fractures did not represent a higher risk of undergoing revision surgery.

Keywords: ACL; ACL reconstruction; Segond fracture; healed Segond fracture.

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Conflict of interest statement

The authors declared that they have no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

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References

    1. Albers M, Shaikh H, Herbst E, et al. The iliotibial band and anterolateral capsule have a combined attachment to the Segond fracture. Knee Surg Sports Traumatol Arthrosc. 2018;26(5):1305-1310. - PubMed
    1. Albtoush OM, Horger M, Springer F, Fritz J. Avulsion fracture of the medial collateral ligament association with Segond fracture. Clin Imaging. 2019;53:32-34. - PubMed
    1. Bere T, Florenes TW, Krosshaug T, et al. A systematic video analysis of 69 injury cases in World Cup alpine skiing. Scand J Med Sci Sports. 2014;24(4):667-677. - PubMed
    1. Bere T, Florenes TW, Krosshaug T, et al. Mechanisms of anterior cruciate ligament injury in World Cup alpine skiing: a systematic video analysis of 20 cases. Am J Sports Med. 2011;39(7):1421-1429. - PubMed
    1. Bock GW, Bosch E, Mishra DK, Daniel DM, Resnick D. The healed Segond fracture: a characteristic residual bone excrescence. Skeletal Radiol. 1994;23(7):555-556. - PubMed