Prevalence of Segond fractures associated with anterior cruciate ligament injuries and their influence on knee joint stability; A case-control study

Author:

Kumahara RyotaroORCID,Kimura Yuka,Sasaki Shizuka,Sasaki Eiji,Maeda Shugo,Tsukada Harehiko,Yamamoto Yuji,Tsuda Eiichi,Ishibashi Yasuyuki

Abstract

Abstract Background The purpose of this study was to determine the prevalence of Segond fractures and to compare knee stability between patients undergoing primary anterior cruciate ligament (ACL) reconstruction with and without Segond fractures pre- and postoperatively. Methods A total of 712 patients who underwent primary ACL reconstruction between 2014 and 2019. Exclusion criteria included patients with multi-ligament knee injuries, skeletally immature patients, osteoarthritis in the knee, combined surgery of high tibial osteotomy, lack of data, and loss to follow-up for at least 2 years. Segond fractures were confirmed using plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Patients with Segond fractures were classified into Group S and without Segond fractures into Group N. Pre- and postoperative Lachman grades, pivot-shift grades, and assessment of side-to-side differences in anterior stability were evaluated. Results Five hundred and forty patients included in this study. There were 22 patients with Segond fractures. Of these, all 22 cases (4.1%) were identified on CT, but only 20 cases (3.7%) were identified on MRI and 18 cases (3.3%) on plain radiographs. There was no significant difference in preoperative Lachman grade or pivot-shift grade between Groups S and N (p = 0.662, p = 0.677, respectively). There was no significant difference in postoperative Lachman grade or pivot-shift grade between Groups S and N (p = 0.685, p = 0.390, respectively). There were no significant differences in preoperative (p = 0.398) or postoperative (p = 0.546) side-to-side differences of anterior stability between Groups S and N. Conclusions Segond fractures were confirmed in 4.1% of the cases on CT scans among patients undergoing primary ACL reconstruction. Segond fractures did not affect preoperative or 2-year follow-up evaluations of knee stability. From these results, we concluded that Segond fractures did not affect the clinical outcomes of the primary ACL reconstruction and that it may not be necessary to treat Segond fractures.

Publisher

Springer Science and Business Media LLC

Subject

Orthopedics and Sports Medicine,Rheumatology

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Lateral meniscal injury without medial meniscal injury indicates the existence of the Segond fracture in ACL-deficient knees;Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology;2024-01

2. The segond fracture: A narrative review of the anatomy, biomechanics and clinical implications;Journal of Clinical Orthopaedics and Trauma;2023-03

3. Anterior cruciate ligament rupture and associated Segond fracture: Incidence and effect on associated ligamentous and meniscal injuries;Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology;2022-10

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