The relationship between a Segond fracture and meniscus injury in patients with anterior cruciate ligament tears

Abstract

BackgroundSegond fracture may be identified when an anterior cruciate ligament (ACL) tear is diagnosed, and it has historically been considered a sign of significant knee trauma indicating intra-articular injury. There are few studies on the correlation between a Segond fracture and meniscus injury. The purpose of this study was to evaluate the relationship between a Segond fracture and meniscus injury in patients with ACL tears. MethodsA retrospective review of all patients undergoing acute ACL reconstruction (less than 1 month from the time of injury) between 2013 and 2020 was performed. The absence or presence of a Segond fracture was confirmed using preoperative radiographs. Demographic data (age, sex and body mass index), injury variables (time from injury and mechanism of injury) and arthroscopic features (meniscal or chondral injury) were analysed to investigate the relationship between a Segond fracture and meniscus injury. ResultsA total of 427 patients were included in the study. The incidence of Segond fractures was 12.4%. Among the patients with a Segond fracture, 15 patients were injured playing soccer (28.3%), 11 patients were injured playing basketball (20.8%), eight patients sustained the injury during racquet sports (15.1%), five patients (9.4%) were injured during less popular sports (such as skiing, ice-skating and boxing), and 14 patients (26.4%) were injured by contact mode of injury. A Segond fracture was a significant risk factor for lateral meniscus tears in patients with ACL tears (adjusted odds ratio, 1.938; 95% confidence interval, 1.078–3.481; P = 0.027). ConclusionThe incidence of Segond fractures in patients with acute ACL tears was higher than that reported in previous studies. A Segond fracture could increase the risk of a lateral meniscus tear in patients with an ACL tear.