Pathogenesis of the Segond Fracture

Description: The Segond fracture is an avulsion fracture involving the proximal tibia immediately distal to the lateral plateau. It was described by Paul Segond in 1879, in cadaveric experiments, as a cortical avulsion of the tibia at the site of insertion of the middle third of the lateral capsular ligament (LCL) resulting from excessive internal rotation and varus stress. Numerous studies have demonstrated an association of the Segond fracture with tears of the anterior cruciate ligament (75%–100% of patients), meniscal tears (66%–75% of patients), damage to the structures of the posterolateral corner of the knee, and other avulsion injuries. Thus, the presence of a Segond fracture may indicate substantial meniscoligamentous injury, and anterolateral rotational instability must be considered to be present until proven otherwise.
CONCLUSION: Anatomic and clinical findings suggest that fibers of the ITT and AOB are important factors in the pathogenesis of the Segond fracture.
Pathogenesis of the Segond Fracture: Anatomic and MR Imaging Evidence of an Iliotibial Tract or Anterior Oblique Band Avulsion 1. Juliana C. Campos, MD, 2. Christine B. Chung, MD, 3. Nittaya Lektrakul, MD, 4. Robert Pedowitz, MD, PhD, 5. Debra Trudell, RA, 6. Joseph Yu, MD and 7. Donald Resnick, MD May 2001 Radiology, 219, 381-386. full text