Segond and tibial spine avulsion fractures

Case contributed by Luke Phillips
Diagnosis certain

Presentation

Landed on right leg after going for a mark playing football. Pain and swelling to same. Unable to weight bare.

Patient Data

Age: 30 years
Gender: Male

There is a moderate to large knee joint effusion.  Avulsion fracture of the tibial spine at the distal ACL attachment.  Avulsion fracture from the lateral knee capsule (Segond fracture).

Case Discussion

Segond fractures are an avulsion fracture of the proximal-lateral tibia and represents a bony avulsion of the anterolateral ligament. They are pathognomonic for an ACL tear. The presence of the tibial spine fracture and large hemarthrosis also indicates a likely ACL injury. 

MRI should be utilized to further investigate this knee injury and the patient should have an orthopedic specialist opinion.

This patient underwent knee arthroscopy and repair of their his ACL.

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