Pathogenesis of the Segond Fracture: Anatomic and MR Imaging Evidence of an Iliotibial Tract or Anterior Oblique Band Avulsion

Abstract

Anatomic and clinical findings suggest that fibers of the ITT and AOB are important factors in the pathogenesis of the Segond fracture.

Segond Fracture Revealed by Ultrasonography

“…Complete disruption of the ACL and medial and lateral meniscal tears often accompany the Segond fracture. [2][3][4] Other lesions, such as popliteus tendon tears 7 and tears of the tibial collateral ligament, 4,7 can also be involved. Associated ligamentous and meniscal injuries identified with MR imaging involve the ACL in 92% to 94% of cases, the lateral meniscus in 23% to 33% of cases, and the medial meniscus in 8% to 30% of cases.…”

“…Associated ligamentous and meniscal injuries identified with MR imaging involve the ACL in 92% to 94% of cases, the lateral meniscus in 23% to 33% of cases, and the medial meniscus in 8% to 30% of cases. 4,7 Abnormal signal intensity changes (ie, low signal on T1-weighted images and high signal on T2-weighted images) suggesting bone marrow contusion are a frequent MR finding (82%-100% of cases). 4,7 They are confined to the lateral tibial rim at the site of the avulsed cortical fragment 4,7 or they extend posteriorly, 4 to the posterior tibial plateau; however, most of them reflect a pattern of injury that is consistent with an impaction fracture of the lateral tibial plateau and femoral condyle and, therefore, complete disruption of the ACL.…”

Posterolateral and Posteromedial Corner Injuries of the Knee

“…Dietz and colleagues, 76 in a study on 20 knees, reported a concomitant ACL injury (confirmed at arthroscopy or physical examination) in 75% of the cases, whereas Goldman and colleagues, 77 in their study on 9 knees, reported an associated ACL injury in 100% of their patients with arthrographic and surgical confirmation. Campos and colleagues 78 suggested the involvement of the iliotibial band and the anterior oblique band of the lateral collateral ligament as important factors in the pathogenesis of the Segond fracture. In their patient population (n 5 17) they reported an association with ACL injuries (94%), bone contusions (82%), meniscal tears (53%), PLC injuries (35%), MCL tears (35%), and popliteus tendon injuries (23%).…”

Travma Sonrasi Dizde Agri

“…[3] Segond kırığını önemli kılan, ön çapraz bağ ve menisküs yırtığı ile birlikte görülme sıklığıdır (ön çapraz bağ yırtığı %75-100, menisküs yırtığı ise %66-75 oranında rapor edilmiştir). [4,5] Eşlik edecek bu lezyonlardan dolayı, direkt grafide bu kırık gözlendiğinde diz MRG'si çekilmelidir. Diz yaralanmalarında hikaye ve diz muayenesi, kapsüler ligament yaralanmaları konusunda hekime doğru tanıyı koymasını sağlasa da, diz travmalı çocuk ve adolesanlarda Segond kırığının yakalanabilmesi için direkt radyografi ile değerlendi-rilme yapılmalıdır.…”