ACL bony avulsion with Segond fracture

Case contributed by Dr Maulik S Patel

Presentation

Knee trauma and pain.

Two subtle but important bony injuries are seen:

  1. bony fragment from the lateral tibial condyle on the AP view represents a Segond fracture due to avulsion at the anterolateral capsular attachment. Segond fractures have a very high association with ACL tears and meniscal injuries and should prompt further evaluation with an MRI.  
  2. avulsed bone fragment is seen anteriorly in the intercondylar region of the tibia due to avulsion of the tibial spine at the distal ACL attachment. 

Case Discussion

This case shows two subtle but important bony injuries; a Segond fracture and tibial spine avulsion at the distal ACL attachment. 

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