The Influence of Segond Fracture on Outcomes After Anterior Cruciate Ligament Reconstruction

Abstract

To determine the prevalence of Segond fractures using computed tomography (CT) and to investigate the effects of Segond fractures on the outcomes of primary anterior cruciate ligament (ACL) reconstruction for isolated ACL injuries. Between January 2010 and July 2015, we retrospectively evaluated 383 patients who underwent primary ACL reconstruction, who underwent CT scans immediately after surgery, and who were available at 2years of follow-up. The absence or presence of a Segond fracture was confirmed using CT. The following parameters were evaluated in all patients at the 2-year follow-up visit: clinical scores (International Knee Documentation Committee subjective score, Lysholm score, and Tegner activity score) and knee joint stability (anterior drawer test, Lachman test, pivot-shift test, and side-to-side difference in anterior tibial translation on Telos stress radiographs). Among 383 patients with primary ACL tears, a Segond fracture was confirmed in 8.9% (n= 34) using 3-dimensional CT. We placed 349 patients into the group with ACL tears without Segond fractures (group A) and the other 34 into the group with ACL tears with Segond fractures (group B). Between the 2 groups, there were no significant differences in the postoperative International Knee Documentation Committee subjective score (P= .97), Lysholm score (P= .17), or Tegner activity score (P= .95). No significant differences in the anterior drawer test (P= .28), Lachman test (P= .45), pivot-shift test (P= .14), and side-to-side difference in anterior tibial translation on Telos stress radiographs (P= .93) between the 2 groups were found preoperatively and postoperatively. The presence of a Segond fracture did not affect knee joint stability in patients with ACL tears. Moreover, the 2 groups did not show significant differences in clinical scores or knee joint stability after undergoing ACL reconstruction. Level III, retrospective comparative study.