[Surgical treatment of Segond fracture and complications].Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2013; 27(9):1045-9ZX
To investigate the injury mechanism, clinical characteristics, and treatments of Segond fracture and complications.
Fifteen patients suffering from Segond fracture were treated between January 2007 and December 2011. There were 10 males and 5 females, aged 16-50 years (mean, 31.8 years). Fracture was caused by traffic accident in 8 cases, by sports in 6 cases, and by bruise in 1 case. Before operation, the knee range of motion (ROM) was (36.60 +/- 8.94) degrees; the Lysholm score was 32.27 +/- 3.73; and the International Knee Documentation Committee (IKDC) score was 42.34 +/- 4.97. The duration from injury to operation was 1-3 weeks with an average of 1.2 weeks. In 12 patients having associated anterior cruciate ligament (ACL) injury, arthroscopic reconstruction of ACL was performed with allogeneic anterior tibial tendon; in 2 patients having associated avulsion fracture of the intercondylar eminence of the tibia, arthroscopic fracture reduction and fixation with Orthocord wire were performed. In 8 patients having associated meniscus injury, meniscus suture and meniscectomy were performed in 3 and 5 patients, respectively. In 7 patients having associated collateral ligament injury, conservative treatment was given in 5 patients, and medial collateral ligament was repair in 2 patients.
All incisions healed primarily without complications of infection and nerve or blood vessel injury. All the patient were followed up 12-16 months (mean, 14.3 months). At 12 months after operation, the results of anterior drawer test, Lachman test, and lateral stress test were all negative. The knee ROM was (129.27 +/- 5.89) degrees, the IKDC score and Lysholm score were significantly increased to 89.45 +/- 3.05 and 87.87 +/- 4.12 at 12 months after operation; all showing significant differences when compared with preoperative values (P < 0.05).
Segond fracture is often combined with ACL, collateral ligament, and meniscus injuries, and the evidence of Segond fracture can strongly suggests the knee injury. Personalized treatment should be chosen according to complications.