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Segond fracture: an MR evaluation of 146 patients with emphasis on the avulsed bone fragment and what attaches to it

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Abstract

Objective

To re-evaluate the Segond fragment emphasizing those structures that attach to the fragment in patients with reported acute/subacute anterior cruciate ligament (ACL) injuries, and to clarify the nomenclature used to describe these structures.

Materials and methods

A search of databases of knee MR examinations over 4.5 years with reported ACL tears yielded 19,726 studies. Using strict exclusion criteria, a total of 146 MR studies with acute/subacute ACL tears were re-assessed with respect to the Segond fragment's size, shape, orientation, location, displacement, attaching soft tissue structures, and associated osseous and/or soft tissue injuries.

Results

Segond fractures were present in 1.25 % of reported acute/subacute ACL tears. The fragment measured 11.9 × 7.3 × 3.27 mm, being thin, ovoid, vertically oriented, situated anterolaterally along the proximal tibial epiphysis, posterior to Gerdy's tubercle and inferior to the lateral tibial plateau, and displaced up to 6 mm laterally. The attached structures were the meniscotibial component of the mid-third lateral capsular ligament (mt-MTLCL) in 58.9 %, both the mt-MTLCL and the posterior fibers of the ITB (pf-ITB) in 35.6 %, and the pf-ITB in 5.48 % of cases. In no case was there an additional attaching structure that did not meet criteria for the mt-MTLCL or the pf-ITB.

Conclusion

The mt-MTLCL most commonly attaches to the Segond fragment, but the pf-ITB can also attach to this fragment. In no case was there an additional attaching structure that did not meet criteria for the mt-MTLCL or the pf-ITB.

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Acknowledgements

Thanks go to Dr Michael Stadnick with Radsource for providing the search engine and some of the cases for this study.

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Authors and Affiliations

  1. Department of Radiology, University of California San Diego Medical Center, 8899 University Center Lane Suite 370, San Diego, CA, 92122, USA

    Dyan V. Flores, Edward Smitaman, Brady K. Huang & Donald L. Resnick

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  1. Dyan V. Flores
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Correspondence to Dyan V. Flores.

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This study complied with HIPAA guidelines and institutional review board approval, along with an exemption status for informed consent.

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Flores, D.V., Smitaman, E., Huang, B.K. et al. Segond fracture: an MR evaluation of 146 patients with emphasis on the avulsed bone fragment and what attaches to it. Skeletal Radiol 45, 1635–1647 (2016). https://doi.org/10.1007/s00256-016-2479-3

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  • DOI: https://doi.org/10.1007/s00256-016-2479-3

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