Pathology
- 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
Symptoms
- 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
Management
- While the fracture itself is inconsequential, it’s presence indicates likely damage to the ACL and Medial Meniscus