Abstract
Background
The anterolateral complex has been demonstrated to assist with rotational stability
and prevention of anterior tibial translation during the pivot shift. In this study
the Segond fracture is used as a surrogate for an anterolateral complex injury to
determine if there is an association between Segond fracture and increased posterior
tibial slope.
Methods
Patients’ charts and radiographs were analyzed retrospectively for the presence of
Segond fractures on injury radiographs. These patients, the Segond cohort, were then
age and gender matched to a control cohort. Demographic as well MRI measurements of
medial and lateral posterior tibial slope and lateral-to-medial slope asymmetry were
collected for each cohort. Secondary outcome of anterior cruciate ligament reconstruction
failure data was also collected.
Results
The Segond group demonstrated a statistically significantly greater lateral posterior
tibial slope (8.42° versus 6.55°, P = 0.003) as well as medial posterior tibial slope (6.57° versus 5.34° degrees, P = 0.045). There was no significant differences between lateral-to-medial asymmetry
(2.18°versus 1.83°, P = 0.246).
Conclusion
Patients with Segond fractures at the time of anterior cruciate ligament injury have
increased medial and lateral posterior tibial slope. This may relate to increased
rotational and translational instability associated with anterolateral complex injuries.
Surgeons treating these patient may use this information to counsel their patients
on the risks of associated pathology at the time of arthroscopy such as lateral meniscal
posterior root tears.
Keywords
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Article info
Publication history
Published online: August 02, 2022
Accepted:
July 15,
2022
Received in revised form:
March 26,
2022
Received:
December 22,
2021
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.