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Review
. 2023 Feb 13:38:102127.
doi: 10.1016/j.jcot.2023.102127. eCollection 2023 Mar.

The segond fracture: A narrative review of the anatomy, biomechanics and clinical implications

Sean Kean Ann Phua  1 , Jia Ying Lim  1 , Tianpei Li  2 , Sean Wei Loong Ho  1
Affiliations
Review

The segond fracture: A narrative review of the anatomy, biomechanics and clinical implications

Sean Kean Ann Phua et al. J Clin Orthop Trauma. .

Abstract

The Segond fracture is commonly regarded as pathognomonic for significant intra-articular pathology such as an anterior cruciate ligament (ACL) tear. There is worsened rotatory instability in patients with concomitant ACL tear and Segond fracture. Current evidence does not suggest that a concomitant and unrepaired Segond fracture leads to worst clinical outcomes after ACL reconstruction. However, there remains a lack of consensus on several aspects of the Segond fracture such as its exact anatomical attachments, ideal imaging modality for detection and indication for surgical treatment. There is currently no comparative study evaluating the outcomes of combined ACL reconstruction and Segond fracture fixation. More research is necessary to deepen our understanding and establish consensus on the role of surgical intervention.

Keywords: ACL; Anterolateral; Ligament; Orthopaedic; Reconstruction; Sports.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Segond fracture visualized on different imaging modalities.Left figure: Anterior-posterior radiograph of the left knee demonstrating a Segond fracture (arrow) visualized as a thin, curvilinear bony fragment adjacent to the lateral aspect of the proximal tibial plateau. Right figure: Coronal proton density-weighted magnetic resonance sequence of a right knee, demonstrating an undisplaced Segond fragment (arrowhead) in the same location.
Fig. 2
Fig. 2
Techniques for direct surgical fixation of Segond fracture. A sized-based algorithm was used by Ferretti et al.: For fragments 2 cm2 or smaller, either periosteal suture fixation (left figure), or suture anchor fixation (middle figure) was employed. For fragments larger than 2 cm2, cannulated screw fixation (right figure) was used.
Fig. 3
Fig. 3
The anterolateral ligament (ALL). The ALL originates posterior and proximal to the lateral epicondyle of the femur. It overlaps the LCL proximally as it travels distally to attach to the proximal tibia, just posterior to Gerdy's tubercle. It also gives off fibres that attach to the lateral meniscus..
See this image and copyright information in PMC

References

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