Table of Contents
What is a Segond fracture?
Segond fractures are a type of avulsion fracture on the lateral aspect of the knee. They are relatively common and are highly associated with an underlying anterior cruciate ligament injury. This activity reviews the cause, evaluation, treatment, and prognosis of Segond fractures.
How long does it take for a Segond fracture to heal?
In a mean 59.1 months (range, 24-180 months) of follow-up, the Segond group had the same results regarding anteroposterior and rotational stability as the control group. The authors also mentioned that time to fracture healing was 4 months (range, 3-30 months) after injury.
How do you treat a Segond fracture?
Patients underwent direct Segond fracture repair by either suture alone, suture anchor, or cannulated screw fixation based on the size of the lesion, followed by a 2-incision hamstring autograft intra-articular reconstruction.
Can a Segond fracture heal on its own?
Although the fracture itself is small, the extensive ligamentous injury associated with it usually requires surgical intervention, to correct anterior rotational instability 4. Healing of the Segond fracture is associated with a particular bone excrescence arising below the lateral tibial plateau.
What does Segond mean?
The Segond fracture is a type of avulsion fracture (soft tissue structures pulling off fragments of their bony attachment) from the lateral tibial plateau of the knee, immediately below the articular surface of the tibia (see photo).
How does a Segond fracture occur?
Segond fractures typically occur by forced internal tibial rotation with the knee flexed. This mechanism places tremendous force on the middle portion of the lateral capsule and associated meniscotibial ligament and results in a small bony avulsion.
Why does Segond fracture occur?
Segond fracture is typically the result of abnormal varus, or “bowing”, stress to the knee, combined with internal rotation of the tibia. Reverse Segond fracture, as its name suggests, is caused by abnormal valgus, or “knock-knee”, stress and external rotation.
How Segond fracture happen?
Classically resulting from internal rotation and varus stress of the knee in flexion, the Segond fracture is an avulsion injury of the lateral tibial plateau and midlateral capsule that frequently accompanies ACL rupture. This injury commonly includes meniscal injury.
What is segond?
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). On the frontal knee radiograph, it may be referred to as the lateral capsular sign.
What is a subchondral impaction fracture?
Subchondral insufficiency fractures of the knee occur in association with prolonged weight bearing or repetitive impaction forces to the bone. The clinical hallmark is acute onset of severe and worsening knee pain in the absence of trauma.
How do you treat a subchondral fracture?
We recommend deferring physical therapy immediately after diagnosis of a subchondral insufficiency fracture, with subsequent consideration of short-term physical therapy comprised by non-weight bearing exercise to strengthen the quadriceps muscles, and prompt discontinuation if the patient reports exacerbation of pain.
How is an impacted fracture treated?
Treatment Options for Impaction Fractures Treating an impaction fraction involves more than simply wearing a cast or splint. Surgery is often needed in order to separate the two fragments of bone. Pins, rods, or other surgical hardware may be used to provide support and keep the two fragments separated.
How long do subchondral fractures take to heal?
Traditionally, conservative therapy is continued for 3 months, but it has been demonstrated that in reversible cases of subchondral fracture, bone marrow edema required an average of 5 months to resolve,7 so a longer period of conservative treatment and observation may be preferable.
Does an impacted fracture need surgery?
Fractures that require surgery The goal of fracture treatment is to allow the bone to heal and fuse back together. Often, this can be accomplished by immobilizing the bone for several months with the help of a cast and splint. The more severe the fracture is, the more likely it is that surgery will be recommended.