UMEM Educational Pearls

Category: Orthopedics

Title: Reverse Segond Fracture

Keywords: Reverse Segond Fracture (PubMed Search)

Posted: 5/21/2017 by Michael Bond, MD (Updated: 6/13/2024)
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Question

It is common teaching that a Segond Fracture is associated with ACL tears.  A reverse Segond fracture, avulsion fracture of the knee due to avulsion of the deep fibers of the medial collateral ligament, has also been described that was initially reported as associated with PCL tears.  However,  a more recent study has not been able to collaborate the PCL connection, but has shown that a reverse Segond fracture is associated with multiple ligamentous injuries to the knee.

Take home point:  If you note a Reverse Segond fracture on your plain flips have the patient followup with orthopedics for a possible MRI, as they probably have other ligamentous injuries that might need treatment.
 

Answer

In the study by Peltola et al they looked at 11 years of patients who had CT of their knee and found 10 patiens with a reverse Segond fracture.  They found "Reverse Segond fracture is a rare finding even in a level 1 trauma center. Cruciate ligament injuries appear to be associated with avulsion frac- ture, but every patient does not have PCL injury, as previously reported. Our results do not support the association of knee dislocation with reverse Segond fracture."

For a detailed discussion of Segond Fractures please visit Radiopaedia at https://radiopaedia.org/articles/segond-fracture

For Reverse Segond Fractures please visit https://radiopaedia.org/articles/reverse-segond-fracture

 

References

  1. Peltola EK, Lindahl J, Koskinen SK. The reverse Segond fracture: not associated with knee dislocation and rarely with posterior cruciate ligament tear. Emerg Radiol. 2014;21(3):245-249. doi:10.1007/s10140-013-1192-y.
  2. Kose O, Ozyurek S, Turan A, Guler F. Reverse Segond fracture and associated knee injuries: A case report and review of 13 published cases. Acta Orthopaedica et Traumatologica Turcica. 9999;50(5):587-591. doi:10.1016/j.aott.2016.08.017.