Lateral meniscal tear, medial femoral and tibial condyles bone bruise, posterolateral tibial plateau fracture, and lateral collateral ligament injury are correlated with Segond fracture associated with anterior cruciate ligament injury.

Abstract

To compare measurements and concomitant injuries between anterior cruciate ligament (ACL)-injured patients with Segond fracture (Segond fracture group) and ACL-injured patients without Segond fracture (isolated ACL tear group) to determine the risk factors of the Segond fracture and identify the concomitant injuries pattern of Segond fracture. We retrospectively reviewed 838 patients who underwent ACL reconstruction in two institutions. Forty-five ACL-injured patients with Segond fracture, 45 ACL-injured patients without Segond fracture, and 45 controls were included. Three groups were matched for age and gender. Posterior tibial slope including lateral and medial bony, cartilaginous and meniscal slope, the status of medial and lateral meniscus, the presence of ramp lesion, posterolateral tibial plateau fracture and lateral and medial collateral ligament injury, and bone bruise severity of lateral and medial femoral condyle, tibial condyle, and patella were determined. Factors associated with Segond fracture were lateral meniscus posterior horn tear (odds ratio [OR], 0.08; 95% confidence interval [CI], 0.01-0.51, p = 0.01), bone bruise ≥ Grade 2 on the medial femoral condyle (OR, 14.28; 95% CI, 1.31-155.25, p = 0.03) and medial tibial condyle (OR, 13.55; 95% CI, 1.01-182.14, p = 0.049), posterolateral tibial plateau fracture (OR, 5.84; 95% CI, 1.02-33.42, p = 0.047), and lateral collateral ligament injury (OR, 20.93; 95% CI, 2.58-169.89, p = 0.004). Medial meniscus body tear, ramp lesion, posterolateral tibial plateau fracture, and lateral collateral ligament injury were strongly correlated with each other (all φ = 1.00, p < 0.001). The risk factors for ACL-injured patients with Segond fracture included lateral meniscus posterior horn tear, bone bruise ≥ Grade 2 on the medial femoral condyle and medial tibial condyle, posterolateral tibial plateau fracture, and lateral collateral ligament injury. The medial meniscus body tear, ramp lesion, posterolateral tibial plateau fracture and lateral collateral ligament injury were strong-correlated concomitant injury combinations in ACL injury with Segond fracture. Level III.