Effects of Segond fracture and associated injuries on knee stability

Abstract

Objective: To investigate the effects of Segond fracture and associated injuries on knee stability. Methods: Retrospective analysis of 35 cases of Segond fracture, allpatients had anterior cruciate ligament rupture (100%), including 6 patients (17.1%) with avulsion fracture of tibia intercondylar eminence. There were 8 cases (22.9%) with medial collateral ligament injury. There were 5 cases (14.3%) with lateral collateral ligament injury. There were 20 cases (57.1%) with combined meniscus injury, 5cases (14.3%) with both medial and lateral meniscus injury, 3 cases (8.6%) with only medial meniscus injury, and 12cases (34.3%) with only lateral meniscus injury. All 35 patients underwent surgical treatment, including 35 cases of ligament reconstruction, 6 cases of intercondylar eminence fracture fixation, and 20 cases of meniscus repair. To compare the function and stability of knee joint before operation and 2 years after operation. Results: The Lysholm score for knee joint function on admission was (43.9±5.3) and the IKDC score was (36.1±3.9). All 35 patients were followed up for 24-36 months. X-rays showed that the Segond fractures healed 3 months after surgery. The anterior drawer test, Lachman test, McMurray test, and Lateral stress test were all negative at the last follow-up. 5 patients with lateral meniscus injury had 1 grade pivot shift at the last follow-up. The Lysholm score was (91.7±3.6), and the difference was statistically significant as compared with that before surgery (P<0.05). The IKDC score was (89.0±1.7), and the difference was statistically significant as compared with that before surgery (P<0.05). Conclusion: The indicative effect of Segond fracture on timely detection of combined injuries in the knee joint cannot be ignored. In addition to repairing the intra-articular injuries, more attention should be paid to the anterolateral structural stability of the knee joint. For Segond fracture patients with higher pivot shift grade may have residual axial migration after surgery, so ALL reconstruction surgery may be considered.