LATERAL TIBIAL AVULSION FRACTURES AND DISRUPTIONS TO THE ANTERIOR CRUCIATE LIGAMENT - A CLINICAL-STUDY OF THEIR INCIDENCE AND CORRELATION

Avulsion fractures of the lateral tibial plateau, known as the lateral capsular sign, are increasingly associated with anterior cruciate lig ament (ACL) ruptures. This phenomenon, known as the Segond fracture, i s a bony avulsion of the meniscotibial ligament. Stress, which can lea d to an avulsion of this kind, almost always occurs during knee flexio n and internal tibial rotation, and in most cases only after damage to the primary ACL stabilizer. Examination of 151 ACL ruptures revealed a Segond fracture in 9% of patients. Nearly all were caused by sports injuries and, understandably, the accident mechanism always included k nee flexion and internal rotation of the tibia. In a similarly large n umber of other knee injuries without damage to the ACL, only one case of a Segond fracture was found. This phenomenon, which is easy to dete ct by radiograph, can thus be regarded as a strong indication of the p resence of a ligament injury.