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

BMC Musculoskeletal Disorders

Harehiko Tsukada¹  Shugo Maeda²  Ryotaro Kumahara³  Eiji Sasaki³  Yuji Yamamoto³  Yasuyuki Ishibashi³  Shizuka Sasaki³  Yuka Kimura³  Eiichi Tsuda⁴ 

[1] Department of Orthopaedic Surgery, Aomori City Hospital, Aomori, Japan;Department of Orthopaedic Surgery, Aomori Rosai Hospital, Hachinohe, Japan;Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, 036-8562, Hirosaki, Japan;Department of Rehabilitation Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan;

关键词: Segond fracture;    Anterior cruciate ligament injury;    Anterior cruciate ligament reconstruction;    Knee joint stability;    Knee;   

DOI  :  10.1186/s12891-022-05127-w

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsA 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.ResultsFive 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.ConclusionsSegond 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.

【 授权许可】

CC BY