Segond fracture combined with tibial plateau fracture.

Abstract

The objective of our study was to examine the coexistence of Segond fracture in tibial plateau fractures and to assess the prevalence of anterior cruciate ligament (ACL) rupture and meniscal tear when those fractures coexist. This retrospective study was conducted at a level 1 trauma center. A total of 1203 emergency department knee trauma MDCT examinations were evaluated. Surgical findings served as the reference standard for intraarticular injuries. A total of 33 patients with a Segond fracture were found. Of these patients, 10 had isolated Segond fractures (surgery, n = 7) and 23 patients (surgery, n = 20) had a Segond fracture associated with a tibial plateau fracture. Patients with both fractures had significantly fewer anterior cruciate ligament (ACL) ruptures (20% vs 71%, p = 0.023) and more avulsion fractures of the ACL (50% vs 0%, p = 0.026) than patients with isolated Segond fractures. For meniscal injuries, the corresponding numbers were 25% and 57% (p = 0.175), respectively. In approximately one of every 32 tibial plateau fractures, a Segond fracture also coexists. Patients with a Segond fracture combined with a tibial plateau fracture have a high risk of avulsion fracture of the ACL.