July 17, 2020
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Anterolateral ligament attachment found in all patients with ACL injury, Segond fractures

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Patients diagnosed with ACL injuries and Segond fractures had complete anterolateral ligament insertion on the avulsed bony fragment, though the posterior portion of the iliotibial band had a lower rate of attachment, according to findings.

Paulo Victor Partezani Helito, MD, and colleagues examined MRI traits of Segond fractures including anterolateral ligament (ALL) and iliotibial band (ITB) integrity, as well as fragment size and location.

“Although Segond fractures are undoubtedly bone avulsion, there is debate regarding which structure is attached to the bone fragment, with much variability in recent literature,” Partezani Helito, and colleagues wrote.

The researchers evaluated data from a retrospective cross-sectional study with MRI scans between 2016 and 2019 featuring terms related to ‘Segond’ in the results. Images were used to assess fragment dimensions and distances from anatomic landmarks.

From MRIs, investigators identified 48 knees of patients diagnosed with ACL and Segond injuries. ALL edema was found in 58.3% of cases, with tears found in three cases.

There was ALL attachment to bone fragments in all cases and the ITB was identified in 52.1% of cases, the researchers wrote.

Greater dimension and volume of fragments led to a higher likelihood of ITB fiber insertion, the investigators wrote. It was also identified that the narrower the distance from the fragment to the center of Gerdy’s tubercle, the greater the probability of ITB fibers being attached.

Interobserver correlation varied from 0.87 to 0.97 for all measurements, the researchers wrote.

“Segond fracture fragment size was predictive for the structures attached to it,” they wrote.