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. 2021 Aug;56(4):533-536.
doi: 10.1055/s-0040-1702956. Epub 2020 Mar 23.

Osteochondral Segond Fracture Associated with Fibular Head Avulsion Fracture - "Arcuate Sign"

Frederico Silva Pimenta  1 , Renata Gabriela Pereira Cunha  1 , Lorran Fabrini de Araújo Rocha  1 , Arthur Ribeiro Oliveira  1 , Marco Túlio Lopes Caldas  1 , Thiago Saldanha Gonçalves  1
Affiliations

Osteochondral Segond Fracture Associated with Fibular Head Avulsion Fracture - "Arcuate Sign"

Frederico Silva Pimenta et al. Rev Bras Ortop (Sao Paulo). 2021 Aug.

Abstract

A deviated osteochondral fracture of the anterolateral tibia associated with fibular head avulsion in a 50-year-old patient is reported. In general, avulsion fracture of the iliotibial tract is associated with injuries in the cruciate ligament, in the meniscus and in lateral knee structures, as in the case herein reported.

Keywords: femoral fractures; knee injuries; tibial fractures.

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Conflict of interest statement

Conflito de Interesses Os autores declaram não haver conflito de interesses.

Figures

Fig. 1
Fig. 1
( A ) Anteroposterior (AP) radiograph of the opening of the lateral joint space and bone fragment of the anterolateral tibia (circle) and avulsion of the head of the fibula (arrow). ( B ) Profile radiograph. ( C ) Radiograph after transarticular external fixation.
Fig. 2
Fig. 2
( A ) Imaging exam under varus stress showing an enormous opening of the lateral joint space and in ( B ) the posterior drawer under stress without posterior translation of the tibia.
Fig. 3
Fig. 3
( A ) Osteochondral fragment inserted into the iliotibial tract and ( B ) osteochondral fragment of the anterolateral tibia. ( C ) Fragment repositioned on the tibial plateau. The arrow indicates a bone defect on the tibial plateau, and the arrowhead indicates the lateral meniscus.
Fig. 4
Fig. 4
( A ) Fixation of the osteochondral fragment with Hebert screws. ( B ) Repair of the lateral meniscus, of the lateral collateral ligament, and of the femoral biceps tendon. ( C and D ) Postoperative AP and profile radiographs.
Fig. 1
Fig. 1
( A ) Radiografia em incidência anteroposterior (AP) da abertura do espaço articular lateral, de fragmento ósseo da tíbia anterolateral (círculo), e da avulsão da cabeça da fíbula (seta). ( B ) Radiografia em perfil. ( C ) Radiografia após fixação externa transarticular.
Fig. 2
Fig. 2
( A ) Exame de imagem sob estresse em varo demonstrando enorme abertura do espaço articular lateral, e em ( B ) gaveta posterior sob estresse sem translação posterior da tíbia.
Fig. 3
Fig. 3
( A ) Fragmento osteocondral inserido no trato iliotibial, e ( B ) fragmento osteocondral da tíbia anterolateral. ( C ) Fragmento reposicionado no platô tibial. A seta indica defeito ósseo no platô tibial, e a ponta da seta, o menisco lateral.
Fig. 4
Fig. 4
( A ) Fixação do fragmento osteocondral com parafusos de Hebert. ( B ) Reparo do menisco lateral, do ligamento colateral lateral, e do tendão do bíceps femoral. ( C e D ) Radiografias AP e de perfil pós-operatórias.
See this image and copyright information in PMC

References

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