Segond Fracture


  • With the same mechanism that would rupture an ACL (twisting on a semiflexed knee, hyperextension)
  • The Segond fracture (or lateral capsular sign) is an avulsion fragment of the lateral tibial plateau, which corresponds to the distal insertion point of the lateral capsular ligament or lateral meniscotibial ligament.
  • —Hess et al (1994) found that of 151 patients with ACL lesions, 9% had Segond Fractures, whereas control group there was <1%
  • —Goldman et al (1988) found —75–100% correlation with ACL rupture and 66-75% association with meniscal tears


  • Similar to ACL rupture:
    • Swelling (may well have a haemarthrosis)
    • Reduced range of motion
    • Pain
    • Difficulty weightbearing
    • Feeling of or actual instability
    • Positive Lachman’s test
  • X-ray findings
    • Avulsion fracture from the lateral aspect of the proximal tibia



  • While the fracture itself is inconsequential, it’s presence indicates likely damage to the ACL and Medial Meniscus