Reverse Segond fracture
Citation, DOI, disclosures and article data
Citation:
Stanislavsky A, Knipe H, Rasuli B, et al. Reverse Segond fracture. Reference article, Radiopaedia.org (Accessed on 14 Dec 2024) https://doi.org/10.53347/rID-19507
Permalink:
rID:
19507
Article created:
17 Sep 2012,
Alexandra Stanislavsky ◉
Disclosures:
At the time the article was created Alexandra Stanislavsky had no recorded disclosures.
View Alexandra Stanislavsky's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Henry Knipe had no recorded disclosures.
View Henry Knipe's current disclosures
Revisions:
12 times, by
9 contributors -
see full revision history and disclosures
Systems:
Synonyms:
- Reverse Segond fractures
Reverse Segond fracture is one of the avulsion fractures of the knee, which is due to the avulsion of the deep fibers of the medial collateral ligament (also known as the meniscotibial or coronary ligament) involving the medial proximal tibia adjacent to the articular surface. It is the opposite of the Segond fracture, which involves the lateral proximal tibia.
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Epidemiology
Associations
Clinical presentation
The reverse Segond fracture is thought to result following external rotation of the knee, with applied valgus stress 1 (cf. Segond fracture: internal rotation and varus stress).
Unlike the Segond, which is often seen with a sporting injury, the reverse Segond appears to occur with higher velocity injuries, such as being struck by a motor vehicle 2 and may be associated with knee dislocation.
Pathology
This cortical fracture is thought to result from avulsion of the deep capsular component of the medial collateral ligament 1.
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Radiographic features
Plain radiograph
The characteristic finding is a small, elliptic bone fragment arising from the medial articular surface of the proximal tibia.
MRI
The finding of this injury on plain film or CT should prompt further evaluation with MRI, as these injuries are commonly associated with:
- medial meniscus tears
- posterior cruciate ligament (PCL) injuries, ranging from intrasubstance tears to avulsion
MRI will also demonstrate disruption of the medial collateral ligament. There may be associated lateral tibial plateau compression.
Quiz questions
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References
- 1. Gottsegen C, Eyer B, White E, Learch T, Forrester D. Avulsion Fractures of the Knee: Imaging Findings and Clinical Significance. Radiographics. 2008;28(6):1755-1770. doi:10.1148/rg.286085503
- 2. Escobedo E, Mills W, Hunter J. The "Reverse Segond" Fracture: Association with a Tear of the Posterior Cruciate Ligament and Medial Meniscus. AJR Am J Roentgenol. 2002;178(4):979-83. doi:10.2214/ajr.178.4.1780979
- 3. Green, David P. Rockwood and Green's Fractures in Adults. (2010) ISBN: 1605476773
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