Presentation
Sudden onset of left knee pain following skiing injury.
Patient Data
Left knee radiographs demonstrate fracture from the lateral aspect of the tibial plateau (Segond fracture), avulsion from the medial femoral condyle (Steida fracture), and tibial intercondylar eminence.
Suprapatellar effusion with fat-fluid level, in keeping with lipohemarthrosis.
CT left knee confirms:
fracture of the lateral aspect of proximal tibia (Segond fracture)
avulsion of MCL attachment at the medial femoral condyle (Steida fracture)
ACL avulsion fracture of the tibial intercondylar eminence, with mild retraction
Moderate lipohemarthrosis.
Case Discussion
Multiple avulsion fractures are demonstrated in this case: Segond fracture, Steida fracture and ACL avulsion fracture.
This pattern of injury is highly associated with further soft tissue trauma, particularly ligamentous and meniscal injuries.