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Segond fracture: an indicator for increased risk of lateral meniscus injury in patients with acute anterior cruciate ligament ruptures

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to investigate the incidence and anatomic distribution of meniscus injury in patients who have sustained acute ACL injuries with and without concomitant Segond fracture. We hypothesized that patients who have sustained a torn ACL with a concomitant Segond fracture would have a higher incidence of lateral meniscal injuries than patients with an isolated ACL injury.

Methods

Patients who underwent ACL reconstruction from 2012 to 2022 were retrospectively reviewed. Segond fractures were identified on knee radiographs. Inclusion criteria were age 18–40, injury during sports activity, and reconstruction within 90 days of injury. Sports activity, anatomic location of meniscus injury, and meniscus treatment were documented. Multivariable regression was used to identify predictors of meniscus injury/treatment.

Results

There were 25 of 603 (4.1%) patients who had an ACL tear with concomitant Segond fracture. The incidence of lateral meniscus injury in the Segond group (72%) was significantly higher than in the non-Segond cohort (49%; p = 0.024). A significantly smaller proportion of medial meniscus injuries among patients with Segond fractures were repaired (23.1%) compared to the non-Segond group (54.2%; p = 0.043). Multivariate analysis found patients with Segond fractures to have increased odds of lateral meniscus injury (OR 2.68; [1.09, 6.60], p = 0.032) and were less likely to have medial meniscus injuries repaired (OR 0.35; [0.15, 0.81], p = 0.014). Additionally, males had increased odds of lateral meniscus injury (OR 1.54; [1.08 − 2.91], p = 0.017), which were more likely to require repair (OR 1.48; [1.02, 2.14], p = 0.038).

Conclusions

Among acute ACL injuries, the incidence of lateral meniscus injury is greater among patients with Segond fractures. Patients with Segond fracture were less likely to undergo repair of medial meniscal injuries.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

ACL:

Anterior cruciate ligament

ACLR:

Anterior cruciate ligament reconstruction

ALL:

Anterolateral ligament

OR:

Odds ratio

CT:

Computerized tomography

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Funding

No grant funding was received for this investigation.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, New York University Langone Health, 333 East 38th St, New York, NY, 10016, USA

    Sharif Garra, Michael R. Moore, Zachary I. Li, Jordan Eskenazi, Taylor Jazrawi, Andrew S. Bi, Kirk A. Campbell, Michael J. Alaia & Eric J. Strauss

  2. Division of Orthopedic Surgery, Tel-Hashomer “Sheba” Medical Center, Tel‐Aviv University, Ramat Gan, Israel

    Sharif Garra

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  1. Sharif Garra
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Contributions

SG conceptualized the study idea, co-drafted the original manuscript, and performed data collection. ZIL co-drafted the original manuscript and performed the formal analysis. JT contributed to the writing and editing of the original manuscript. AJH contributed to writing and editing and was involved in project administration. TJ performed data curation and edited the manuscript. ASB assisted with the formal analysis and edited the manuscript. KAC contributed to the methodology and reviewed and edited the manuscript. MJA reviewed and edited the manuscript. EJS designed the methodology and reviewed and edited the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sharif Garra.

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Conflict of interest

K.A.C. receives research support from Arthrex and consults for Mitek. M.J.A. receives research support from Orcosa and consults for Mitek and Bodycad. E.J.S. receives research support from Fidea and Cartiheal and consults for Arthrex, Smith & Nephew, Joint Restoration Foundation, Better PT, Organogenesis, Subchondral Solutions, and Vericel. All disclosures are voluntarily declared and unrelated to the current investigation.

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IRB protocol #19–01430 (New York University School of Medicine).

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Garra, S., Moore, M.R., Li, Z.I. et al. Segond fracture: an indicator for increased risk of lateral meniscus injury in patients with acute anterior cruciate ligament ruptures. Eur J Orthop Surg Traumatol 34, 1883–1891 (2024). https://doi.org/10.1007/s00590-024-03857-2

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