How do you treat a Segond fracture?

Patients underwent direct Segond fracture repair by either suture alone, suture anchor, or cannulated screw fixation based on the size of the lesion, followed by a 2-incision hamstring autograft intra-articular reconstruction.

Can a Segond fracture heal on its own?

Although the fracture itself is small, the extensive ligamentous injury associated with it usually requires surgical intervention, to correct anterior rotational instability 4. Healing of the Segond fracture is associated with a particular bone excrescence arising below the lateral tibial plateau.

What is a Segond fracture?

Segond fractures are a type of avulsion fracture on the lateral aspect of the knee. They are relatively common and are highly associated with an underlying anterior cruciate ligament injury. This activity reviews the cause, evaluation, treatment, and prognosis of Segond fractures.

How does ACL injury cause Segond fracture?

Classically resulting from internal rotation and varus stress of the knee in flexion, the Segond fracture is an avulsion injury of the lateral tibial plateau and midlateral capsule that frequently accompanies ACL rupture. This injury commonly includes meniscal injury.

What is Segond?

Segond fracture is an avulsion fracture of the knee that involves the lateral aspect of the tibial plateau and is very frequently (~75% of cases) associated with disruption of the anterior cruciate ligament (ACL). On the frontal knee radiograph, it may be referred to as the lateral capsular sign.

How long is tibial plateau fracture surgery?

Surgical Treatment Sometimes bone graft or types of bone cement are needed to support the joint surface. During these surgeries injured meniscus or tendons are repaired as well. Surgery usually takes 1 to 2 hours.

Who was Dr Segond And what did he discover?

Paul Ferdinand Segond (1851-1912) was a French Orthopaedic Surgeon. Gynaecological approach per vagina to remove uterus (pioneer of the trans-vaginal hysterectomy), myomas and carcinomatous lesion.

How do you rehab a tibial plateau fracture?

0 to 1 week:

1. Ice and modalities to reduce pain and inflammation.
2. Use crutches non-weight bearing for 6 weeks.
3. Brace for 6 weeks in full extension.
4. Elevate the knee above the heart for the first 3 to 5 days.
5. Initiate patella mobility drills.
6. Begin full passive/active knee range of motion exercises.

What is the first aid for avulsion?

Control bleeding with direct pressure and elevation: Use an absorbent clean dressing or whatever clean cloth is available to hold pressure on an open avulsion or degloving injury. The dressing will trap blood and hold it against the open wound, promoting clotting. Clotting will ultimately help to stop the bleeding.

How long does avulsion fracture take to heal?

You might need to wear a cast or splint for a few weeks. Fractures usually take about three to 12 weeks to heal completely. For an avulsion fracture in your pelvis or anywhere else where your healthcare provider can’t apply a cast, a short period of rest followed by crutches is helpful.

When do you start physical therapy after tibial plateau fracture?

Tibial Plateau Fracture Rehab: Weeks 1-6: Your therapist will begin immediately with steps to reduce inflammation, calm pain, and begin to promote healing. The therapist focuses on maintaining knee extension and non-weight-bearing movement to promote healing and to prevent further pain and reinjury.

How do you manage an avulsion wound?

Care for your wound:

1. Clean your wound: Wash your hands with soap and water before and after you care for your wound.
2. Elevate your wound: Prop your injured area on pillows to raise it above the level of your heart.
3. Bandage your wound: Bandages keep your wound clean, dry, and protected from infection.

How do you treat avulsion fractures?

Treatment of an avulsion fracture typically includes resting and icing the affected area, followed by controlled exercises that help restore range of motion, improve muscle strength and promote bone healing. Most avulsion fractures heal very well without surgical intervention.

What indicates a positive Lachman’s test?

On pulling the tibia anteriorly, an intact ACL should prevent forward translational movement of the tibia on the femur (“firm end-feel”). Anterior translation of the tibia associated with a soft or a mushy end-feel indicates a positive test.

What type of injury is a Segond fracture?

The Segond Fracture Is an Avulsion of the Anterolateral Complex. Am J Sports Med. 2017 Aug;45(10):2247-2252. [PubMed: 28499093] 6. Arneja SS, Furey MJ, Alvarez CM, Reilly CW. Segond fractures: not necessarily pathognemonic of anterior cruciate ligament injury in the pediatric population. Sports Health. 2010 Sep;2(5):437-9.

How do you fix a Segond fracture?

Segond fractures can be repaired by either direct suture repair, suture anchor techniques, or screw fixation dependant on the size and characteristics of the fracture. Surgical repair of Segond fractures has shown good results with minimal complications, however, these were not compared to a control group.

How is the Segond fracture of the hip repaired?

Four patients had a concomitant massive disruption of ALC, extending to the posterolateral capsule. Repair of the Segond fracture was performed in 7 patients by use of periosteal stitches, in 4 patients with suture anchors, and in 1 patient, due to a larger fragment, with a cancellous screw (Figure 4).

Is the Segond fracture the bony equivalent of an ALC rupture?

Conclusion The Segond fracture can be considered the bony equivalent of an ALC rupture. This fracture is associated with severe rotational instability of the knee as demonstrated by an increased pivot-shift grade.