Ozkan KOSEB, Selahattin OZYUREKA, Adil TURANB, Ferhat GULERB

Reverse Segond fracture and associated knee injuries: A case report and review of 13 published cases

Reverse Segond fracture is originally described as an indirect radiographic clue for a speciŞc injurycomplex of the knee joint that includes posterior cruciate ligament (PCL) rupture and medial meniscaltear. Herein, we describe a case with reverse Segond fracture associated with PCL avulsion fractureinstead of PCL rupture. According to current literature review, reverse Segond fracture is not onlyassociated with PCL and medial meniscal injuries, but also frequently associated with anterior cruciateligament (ACL) and medial collateral ligament (MCL) injuries. Furthermore, medial meniscus and PCLmay remain intact.© 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

___

Gottsegen CJ, Eyer BA, White EA, Learch TJ, Forrester D. Avulsion fractures of the knee: imagingŞndings and clinical signiŞcance. Radiographics. 2008;28: 1755e1770.

Claes S, Vereecke E, Maes M, Victor J, Verdonk P, Bellemans J. Anatomy of the anterolateral ligament of the knee. J Anat. 2013;223:321e328. http:// dx.doi.org/10.1111/joa.12087.

Goldman AB, Pavlov H, Rubenstein D. The Segond fracture of the proximal tibia: a small avulsion that reflects major ligamentous damage. AJR Am J Roentgenol. 1988;151:1163e1167.

Hall FM, Hochman MG. Medial Segond-type fracture: cortical avulsion off the medial tibial plateau associated with tears of the posterior cruciate ligament and medial meniscus. Skelet Radiol. 1997;26:553e555.

Escobedo EM, Mills WJ, Hunter JC. The"reverse Segond" fracture: association with a tear of the posterior cruciate ligament and medial meniscus. AJR Am J Roentgenol. 2002;178:979e983.

Archbold HA, Sloan S, Nicholas R. A tibial plateau fracture in a knee dislocation: a subtle sign of major ligamentous disruption. Injury. 2004;35:945e947.

Cohen AP, King D, Gibbon AJ. Impingement fracture of the anteromedial tibial margin: a radiographic sign of combined posterolateral complex and posterior cruciate ligament disruption. Skelet Radiol. 2001;30:114e116.

Varney JB. Reverse Segond fracture without PCL injury. Radiol Case Rep. 2012;7: 537.

Engelsohn E, Umans H, Difelice GS. Marginal fractures of the medial tibial plateau: possible association with medial meniscal root tear. Skelet Radiol. 2007;36:73e76.

Angelini FJ, Malavolta EA, D'Elia CO, P ecora JR, Hernandez AJ, Camanho GL. Avulsion fracture of the medial tibial plateau (reverse Segond injury). Acta Ortop Bras. 2007;15:169e170.

Kwon OS, Park MJ, Tjoumakaris FP. Medial and lateral segond fractures in a skeletally immature patient: a radiographic marker for the multiply injured knee. Orthopedics. 2011;34:e772ee775.

Faroug R, Hasan A. Reverse Segond fracture: a case report. Inj Extra. 2009;40: 109e111.

Torisu T. Avulsion fracture of the tibial attachment of the posterior cruciate ligament: indications and results of delayed repairs. Clin Orthop. 1979;143: 107e114.

WajsŞsz A, Makridis KG, Van Den Steene JY, Djian P. Fixation of posterior cruciate ligament avulsion fracture with the use of a suspensoryŞxation. Knee Surg Sports Traumatol Arthrosc. 2012;20:996e999.

Hoogervorst P, Gardeniers JW, Moret-Wever S, van Kampen A. Pseudo- arthrosis repair of a posterior cruciate ligament avulsion fracture. Knee Surg Sports Traumatol Arthrosc. 2010;18:1612e1616.

Lee BK, Nam SW. Rupture of posterior cruciate ligament: diagnosis and treat- ment principles. Knee Surg Relat Res. 2011;23:135e141.

Zhang X, Cai G, Xu J, Wang K. A minimally invasive postero-medial approach with suture anchors for isolated tibial avulsion fracture of the posterior cru- ciate ligament. Knee. 2013;20:96e99.

Chen SY, Cheng CY, Chang SS, et al. Arthroscopic sutureŞxation for avulsion fractures in the tibial attachment of the posterior cruciate ligament. Arthros- copy. 2012;28:1454e1463.

Bali K, Prabhakar S, Saini U, Dhillon MS. Open reduction and internalŞxation of isolated PCL fossa avulsion fractures. Knee Surg Sports Traumatol Arthrosc. 2012;20:315e321.

Nicandri GT, Klineberg EO, Wahl CJ, Mills WJ. Treatment of posterior cruciate ligament tibial avulsion fractures through a modiŞed open posterior approach: operative technique and 12- to 48-month outcomes. J Orthop Trauma. 2008;22: 317e324.