Lateral meniscal injury without medial meniscal injury indicates the existence of the Segond fracture in ACL-deficient knees

Nobutada Suzuki; Atsuya Watanabe; Taishi Ninomiya; Hirofumi Nakajima; Manato Horii; Shotaro Watanabe; Yuki Shiko; Takahisa Sasho

doi:10.1016/j.asmart.2023.11.004

Lateral meniscal injury without medial meniscal injury indicates the existence of the Segond fracture in ACL-deficient knees

Asia Pac J Sports Med Arthrosc Rehabil Technol. 2023 Dec 27:35:59-64. doi: 10.1016/j.asmart.2023.11.004. eCollection 2024 Jan.

Authors

Nobutada Suzuki^{1

2}, Atsuya Watanabe³, Taishi Ninomiya^{2

4}, Hirofumi Nakajima^{2

4}, Manato Horii^{3

5}, Shotaro Watanabe^{2

5}, Yuki Shiko⁶, Takahisa Sasho^{2

5}

Affiliations

¹ Department of Radiology, Eastern Chiba Medical Center, 3-6-1 Okayamadai, Togane, Chiba, 283-8686, Japan.
² Center for Preventive Medicine, Musculoskeletal Disease and Pain, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan.
³ Department of Orthopedic Surgery, Eastern Chiba Medical Center, 3-6-1 Okayamadai, Togane, Chiba, 283-8686, Japan.
⁴ Department of Orthopedic Surgery, Funabashi Orthopedic Hospital, 1-833 Hasamacho, Funabashi, Chiba, 274-0822, Japan.
⁵ Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan.
⁶ Biostatistics Section, Clinical Research Center, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-0856, Japan.

Abstract

Background/objective: The purpose of this study was to find factors indicating the occurrence of the Segond fracture, a specific type of anterolateral ligament injury.

Methods: From January 2015 to December 2017, we retrospectively reviewed the medical records of patients diagnosed with acute anterior cruciate ligament (ACL) injury who underwent reconstruction within 90 days of injury. Diagnosis of the Segond fracture was determined either by magnetic resonance imaging or plain radiographs. Factors examined were: age at surgery, sex, body mass index (kg/m²), status of menisci, and activities led to ACL injury. After univariate screening, multivariate logistic regression analyses were performed. Patients were divided into four groups based on the presence of lateral meniscal (LM) and/or medial meniscal (MM) injuries and compared with respect to the occurrence of Segond fractures.

Results: A total of 375 patients were included (163 males, 212 females), with mean age 25.8 years old. Among them, 22 of 375 (5.9 %) had a Segond fracture. We identified injured lateral menisci (adjusted odds ratio (aOR), 3.029; 95 % Confidence Interval (CI), 1.206-7.609; P = 0.018), intact medial menisci (aOR, 0.229; 95 % CI, 0.065-0.810; P = 0.022), and higher body mass index (aOR, 1.102; 95 % CI, 1.008-1.205; P = 0.034) as factors indicative of the occurrence of Segond fracture. LM injury without MM injury suggested the existence of a Segond fracture.

Conclusion: LM injury without a MM injury indicated the occurrence of a Segond fracture. Higher body mass index also increased the risk for Segond fracture occurrence.

Keywords: Anterior cruciate ligament injury; Anterolateral ligament; Lateral meniscal injury; Medial meniscal injury; Risk factors; Segond fracture.