Glossary
Segond fracture
Quick answer
A Segond fracture is a small flake of bone pulled off the outer edge of the top of the shin bone by a twisting injury. The fragment itself is minor, but it is a strong sign of an ACL tear and other ligament damage, explains Doha knee surgeon Dr. Pablo Gelber at Aman Hospital.
What it is
It is named after Paul Segond, the French surgeon who described it in the nineteenth century. On a front-view X-ray it appears as a thin sliver of bone just beside the outer tibia. It is an avulsion fracture, meaning soft tissue pulled the bone off rather than a direct blow breaking it.
The tissue that pulls it off is the lateral capsule and anterolateral ligament, which tighten when the knee twists inward under load.
Why it matters
A Segond fracture is found in a large proportion of knees with a torn ACL and is rare without one. If it is seen on X-ray, an MRI is needed to check the ACL, menisci and other ligaments.
It also suggests the knee has a significant rotational instability, which surgeons consider when planning an ACL reconstruction. Some add an anterolateral procedure to control rotation, especially in high-risk sports.
How it is treated
The fragment usually heals on its own and rarely needs fixing. Treatment focuses on the associated injuries, most often the ACL. Early care is rest, ice, crutches if needed and physiotherapy to recover movement before any surgery.
Frequently asked questions
Does a Segond fracture need surgery?
The small fracture itself rarely needs surgery. The ACL tear that usually comes with it is often managed with reconstruction in active patients.
Can a Segond fracture happen without an ACL tear?
It is uncommon. Almost all Segond fractures come with an ACL tear, which is why an MRI is advised whenever one is found.
Related
