In adult patients with segond fracture on plain film acl and lcl tears should be assumed unless proven otherwise. The segond fracture then became largely neglected in the orthopaedic literature until woods et al. Segond fracture with anterior cruciate ligament tear in an adolescent segond fracture with anterior cruciate ligament tear in an adolescent. Case of the month segond fracture mcmaster faculty of. Segond p 1879 recherches cliniques et experimentales sur les epanchements sanguins du genou par entorse. Mar 20, 20 patients with segond fracture require close orthopedic follow up for presumed ligamentous injury in addition to the usual rice, crutches, nwb, knee immobilizer. Reverse segond fracture almost always result from high energy trauma to the knee and usually affect young adults. In our series, the segond fracture was uniformly associated with detachment of the capsular portion of the lateral collateral ligament and tears of the anterior. The segond fracture is a small vertical avulsion injury of the lateral aspect of the proximal tibia just distal to the plateau. Ebraheims animated educational video describes avulsion fractures and bone bruises around the knee. Treatment usually involves reduction putting the broken bone back into position and immobilising the wrist in a plaster cast.
Nouvelle bible segond nbs download the free bible app. The french surgeon paul segond first described this avulsion. On the frontal knee radiograph, it may be referred to as the lateral capsular sign. Paul segond, the segond fracture is now widely accepted as a pathognemonic radiographic marker of anterior cruciate ligament injury. We report a reverse segond fracture associated with anterior cruciate ligament tibial avulsion fracture and anteromedial tibial rim fracture.
Segond fracture the segond fracture is a type of avulsion fracture soft tissue structures tearing off bits of their bony attachment of the lateral tibial condyle of the knee, immediately beyond the surface which articulates with the femur. We describe three cases of a similar fragment on the opposite medial aspect of the proximal tibia representing an. Chung, nittaya lektrakul, robert pedowitz, debra trudell, joseph yu, donald resnick. Segond fracture with intra operative signs of displacement. A frontal radiograph of the knee demonstrates an avulsion fracture of the lateral tibial plateau. Surgical treatment of segond fractures in acute anterior cruciate. As per the law relating to information storage and personal integrity, you have the right to oppose art 26 of that law, access art 34 of that law and rectify art 36 of that law your personal data. Surgical treatment of segond fractures in acute anterior. The segond fracture is an avulsion of the lateral capsular ligament, which manifests as an elliptic bony fragment off the lateral proximal tibia, that has a high association with tear of the anterior cruciate ligament 1,2,3. Mri of the knee revealed an isolated rupture of the acl b, gap in the ruptured acl is bracketed. Unlike previous reports, the combination of reverse segond fracture, anteromedial tibial rim fracture.
Reverse segond fracture and associated knee injuries. Jonathan pirie, two experienced pediatric em docs from the hospital for sick children in toronto discuss their approach to a variety of common, occult, challenging and easy to miss pediatric orthopedics diagnoses including. Avulsion lesions are a possible goal for refixing important lateral structures. Surgery may be considered for more seriously displaced fractures. When an anterior external avulsion injury of the tibia, characteristic of the fracture described by segond in 1879, is seen on. While previous studies evaluated the role of the anterolateral ligament all and complex injuries on rotational stability of the knee, there are no studies on the biomechanical effect of segonds fracture in an acl deficient knee. The fracture is considered pathogonomic for acl tears. In 4 acute cases with a positive lateral capsular sign i.
Find, read and cite all the research you need on researchgate. The segond fracture is an avulsion fracture involving the proximal tibia immediately distal to the lateral plateau. A segond fracture is a small vertical avulsion injury of the lateral aspect of the proximal tibia just distal to the plateau. Rupture complete du tendon quadricipital rupture complete du tendon quadricipital. Christian events in mauritius is a free hub of information to spread the word, such that a maximum of people can attend the various teachings, seminars, worship concerts, prayers, special deliverance, international pastors, etc.
Is treatment of segond fracture necessary with combined. These findings were all associated with disruption of the posterior cruciate ligament and a peripheral medial meniscal tearthe socalled reverse segond fracture. Absolute isolated avulsion of the anterolateral complex of. Paul segond was born in paris, the son of anatomist louisauguste segond 18191908. Because of the high rate of associated ligamentous and meniscal injury, the presence of a segond or reverse segond. Reverse segond fracture radiology reference article. It is the opposite of the segond fracture, which involves the lateral proximal tibia. Herein, we describe a case with reverse segond fracture associated with pcl avulsion fracture instead of pcl rupture. Background segonds fracture is a wellrecognised radiological sign of an anterior cruciate ligament acl tear. This surgeon from lyons wrote a paper published in his posthumous. Reverse segond fracture associated with anteromedial tibial.
The segond fracture is a type of avulsion fracture from the lateral tibial plateau of the knee. However, the anatomy of the softtissue attachments responsible for the avulsion of sfs has been a cause of controversy. Anatomic and mr imaging evidence of an iliotibial tract or anterior oblique band avulsion. A small avulsion fracture from the directly lateral surface of the lateral tibial condyle results from excessive tension on the lateral capsular ligament of the knee joint. The mechanism of injury is internal rotation and various stresses, which causes abnormal tension on the central portion of the lateral capsular ligament. Segond fracture, lateral capsular ligament, anterior cruciate ligament, knee. Ultrasound imaging mri 3 6 % reference 1 x ray 9 % ref 2 ultrasound 28 % ref 3 reference reference 1 resnick. The arthroscopical and radiological correlation of lever sign test for the diagnosis of anterior cruciate ligament rupture. An avulsion fracture of the anterolateral margin of the lateral tibial plateau, associated with anterior cruciate ligament acl tears.
The segond fracture is an important radiographic sign that is critical to recognize because it is generally associated with anterior cruciate ligament disruption. Adolescent segond fracture with an intact anterior cruciate. The aim of this study was to evaluate the effect of a. There is a vertical avulsion fracture of the lateral aspect of the proximal tibia black arrow. Combined acl reconstruction and segond fracture fixation. Reverse segond fracture is one of these fractures and it should alert the physicians for further diagnostic imaging and proper care for the patient. Reverse segond fracture is one of the avulsion fracture of the knee, which is due to avulsion of the deep fibers of the medial collateral ligament also known as the menisciotibial or coronary ligament involving the medial proximal tibia adjacent to the articular surface. It is the result of a forced internal rotation with varus stress injury in a flexed knee. A 31yearold male patient presented with an injury to his right knee that resulted in acl tear and a sf. Pdf on sep 1, 2011, florian desmots and others published segond fracture.
Avulsion fractures in the appendicular skeleton are a result of stress on a specific structure that is firmly attached to bone. Highlight or bookmark your favorite verses, make verse images that you can share, and attach public or private notes to bible passages. To identify the softtissue structure causative for the segond fracture, a study was set up to compare anatomic details of the tibial insertion of the recently characterized all in cadaveric knees n 30 with radiologic data obtained from patients n 29 with a possible segond fracture based on an imaging protocol search. Reverse segond fracture is an uncommon avulsion fracture of the tibial attachment of the deep portion of the medial collateral ligament of the knee. Segond fracture avulsion of the proximal, lateral tibia best seen on the anteroposterior view or tunnel view of the knee in about 75% of cases, there is an associated injury of the anterior cruciate ligament acl. This document has been generated from xsl extensible stylesheet language source with. We describe three cases of a similar fragment on the opposite medial aspect of the proximal tibia representing an avulsion of the deep capsular component of the medial collateral ligament. It was described by paul segond in 1879, in cadaveric experiments, as a cortical avulsion of the tibia at the site of insertion of the middle third of the lateral capsular ligament lcl resulting from excessive internal rotation and varus stress. In 1879, the french surgeon paul segond 28 conducted a series of cadaveric studies and reported that a relatively constant avulsiontype fracture occurred on the anterolateral aspect of the tibial plateau with forced internal rotation of the knee. I don t microsoft your computer sim card will cure on this 1 consumer 1. Reverse segond fracture is originally described as an indirect radiographic clue for a specific injury complex of the knee joint that includes posterior cruciate ligament pcl rupture and medial meniscal tear. It results from excessive internal rotation and varus stress. Unlike the segond, which is often seen with sporting injury, the reverse segond appears to occur with higher velocity injuries, such as being struck by a motor vehicle 2, and may be associated with knee dislocation.
The reverse segond fracture is thought to result following external rotation of the knee, with applied valgus stress 1 c. Absolute isolated avulsion of the anterolateral complex of the knee. Deveci a, cankaya d, yilmaz s, ozdemir g, arslantas e, bozkurt m. In older people, a broken wrist from a fracture at the lower end of one of the two forearm bones can result from a fall onto an outstretched hand. Twenty patients 16 male, 4 female with a combined acl tearuntreated segond fracture with a mean age of 26. The arthroscopical and radiological correlation of lever sign test for the diagnosis of anterior. Cest lui qui nous a faits, et nous lui appartenons. Adolescent segond fracture with an intact anterior. The segond fracture is a type of avulsion fracture soft tissue structures tearing off bits of their bony attachment of the lateral tibial condyle of the knee, immediately beyond the surface which articulates with the femur. Open sf fixation and arthroscopic acl reconstruction were performed. Recognition of this fracture on an anteroposterior radiograph of a traumatized knee represents substantial evidence of major injury to the lateral joint capsule. Clinical analysis of acute segond fractures confirmed the frequent attachment of the itt and aob to the avulsed fragment. Segond fracture is an avulsion fracture of the knee that involves the lateral aspect of the tibial plateau and is very frequently 75% of cases associated with disruption of the anterior cruciate ligament acl.
Reverse segond fracture is one of the avulsion fracture of the knee, which is due to avulsion of the deep fibers of the medial collateral ligament also known as the menisciotibial or coronary ligament involving the medial proximal tibia adjacen. The segond fracture sf is considered pathognomonic of an anterior cruciate ligament acl tear. Primary injury plain x ray information avulsion lesions are a possible goal for refixing important lateral structures. The segond fracture, also referred to as a lateral capsular sign or a lateral tibial plateau avulsion fracture, implies disruption of the meniscotibial portion of the middle onethird of the. Kerr hd 1990 segond fracture, hemarthrosis, and anterior cruciate ligament disruption. Com is registrered at the cnil, declaration n 1286925. Segond fracture, fixation burt klos icone the netherlands. A description of the anterior oblique band of the fibular collateral ligament was provideda firm band. Segonds fracture is a wellrecognised radiological sign of an anterior cruciate ligament acl tear. The segond fracture is an avulsiontype fracture located on the anterolateral aspect of the tibia associated with a ligament recently termed the. A segond fracture has an associated acl injury 75% to 100% of the time, 3,5 and it occurs in approximately 9% to 12% of all acl tears. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Reverse segond fracture associated with anteromedial.
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