Abstract
The existence and anatomy of the anterolateral ligament (ALL) of the knee are a somewhat controversial topic in orthopaedic surgery. The fixation of the avulsion fracture of the ALL (Segond fracture), associated with periarticular knee fractures, is rarely given much consideration while the major fracture fragments are reconstructed. This study aims to confirm the existence of ALL and evaluate the clinical outcomes of surgical management for avulsion fractures, involving its insertion, when associated with periarticular knee fractures. Twenty-three patients (16 males and 7 females) with avulsion fractures of the ALL associated with periarticular knee fractures were fixed with a spider plate, cannulated screw, or suture anchor. Eight patients were diagnosed with distal femoral fracture, 10 with tibial plateau fracture, and 5 with tibial eminence avulsion fracture. All patients underwent X-rays at follow-up. Clinical and functional outcomes were assessed with the pivot-shift test, objective and subjective International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner activity scale. The ALL was found and identified as a distinct ligamentous structure in all patients. Prior to Segond repair, patients had significantly more instability, as determined by pivot-shift test, than seen postoperatively (p < 0.0001). At final follow-up, the mean subjective IKDC score was 83.2 ± 10.3. Fourteen patients were graded A, 6 were graded B, and 3 was graded C on the IKDC objective score. The mean Lysholm score was 85.4 ± 12.2. The mean Tegner score was 7.5 ± 1.2. This study confirmed that the ALL is a distinct structure in the anterolateral portion of the knee. The fixation of the avulsion fracture of the ALL associated with periarticular knee fractures can be an effective procedure without specific complications. Long-term and comparative follow-up studies are necessary to confirm the effects.
Highlights
To confirm the existence of the anterolateral ligament (ALL) and evaluate the clinical outcomes of surgical management for avulsion fractures involving its insertion when associated with periarticular knee fractures
Helito et al [19] reported that the ALL was present in all dissected fetal knees, while Sabzevari et al [39] claimed that they could not prove the presence of a distinct ligamentous structure in the anterolateral complex area
The tibial insertion was located on the lateral edge of the tibial plateau, at the midpoint between Gerdy’s tubercle and the fibular head (Figure 1)
Summary
To confirm the existence of the ALL and evaluate the clinical outcomes of surgical management for avulsion fractures involving its insertion when associated with periarticular knee fractures. In 1879, Paul Segond first described the existence of a “pearly, resistant, fibrous band” at the anterolateral aspect of the human knee attached to an eponymous Segond fracture [5, 30]. This band was not routinely discussed, identified, and confirmed during the subsequent century. Helito et al [19] reported that the ALL was present in all dissected fetal knees, while Sabzevari et al [39] claimed that they could not prove the presence of a distinct ligamentous structure in the anterolateral complex area
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
