Segond fracture and bony avulsion of ACL origin

Case contributed by Chris O'Donnell

Presentation

Fall on left knee

Patient Data

Age: 13 years
Gender: Male

Segond fracture of the lateral tibial plateau rim (arrow) at the capsular attachment is virtually always associated with an ACL rupture.  In this case (ie young boy) the bone is weaker than the ligament thus there has been avulsion of the ligament origin with leak of bone marrow into the joint space leading to a lipohemarthrosis (arrow). Prognosis is good in this case as long as the bone is repositioned on the tibial eminence - this can be difficult due to the transverse meniscal ligament intervening.

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