Presentation
Swelling, pain, and restricted range of motion of the right knee due to sports injury.
Patient Data
On the AP view of the x-ray, a curved or elliptical bony fragment is seen projecting parallel to the lateral aspect of the tibial plateau. This finding, known as the lateral capsular sign, is consistent with a Segond fracture, a type of avulsion fracture of the knee.
MRI right knee findings:
grade II injury of the lateral patellar retinaculum, lateral collateral ligament (LCL), popliteus tendon, and iliotibial band
joint effusion (~8 mm)
bone marrow oedema scattered in the lateral femoral condyle and lateral tibial plateau
soft tissue swelling in the anterolateral aspect of the knee
Case Discussion
A Segond fracture is a type of avulsion fracture of the knee involving the lateral aspect of the tibial plateau. This injury results from an avulsion of the iliotibial band and the anterior oblique band of the fibular collateral ligament.
It typically occurs due to ainternal rotation and valgus stress on the knee.
internal rotation of the tibia causes excessive tension on the iliotibial band (ITB), leading to avulsion of a small bony fragment from the lateral tibial plateau
valgus stress further strains the anterior cruciate ligament (ACL), often resulting in a complete ACL tear
this fracture is considered a strong indirect sign of ACL injury, with 75-100% of Segond fractures associated with ACL tears
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