Erno Peltola, Abstract Co-Author: Nothing to Disclose

Jan Lindahl, Abstract Co-Author: Nothing to Disclose

Seppo K. Koskinen MD, PhD, Presenter: Nothing to Disclose

To assess the incidence of reverse Segond fracture, to examine the associated ligamentous injuries, and to examine how often patients with a tibial plateau fracture or knee dislocation also have a reverse Segond fracture.

At Level 1 trauma center, 11-year-period of emergency department MDCT examinations for knee trauma were evaluated for Segond and reverse Segond fractures. Surgical findings served as the reference standard for intra-articular injuries. The hospital discharge register was searched for the diagnosis of knee dislocation (ICD- 10 code S83.1) from August 2000 to the end of August 2011.

A total of 1553 knee MDCT examination were evaluated. Ten patients with a reverse Segond fracture were found, comprising 0.64% of emergency room acute knee trauma MDCT examinations. 8 patients who had a reverse Segond fracture combined with a tibial plateau fracture, and of these seven were operated: three had an avulsion fracture of ACL, and one had an avulsion fracture of PCL, two had a lateral meniscal tear and two had an MCL tear. The ratio of reverse Segond fractures to Segond fractures was 1 : 4. Of the tibial plateau fractures, 0.9% coexisted with reverse Segond fracture. None of the 71 knee dislocation patients had a reverse Segond fracture.

Reverse Segond fracture is a rare finding even in a Level 1 trauma center. PCL injury is not common when tibial plateau fracture is combined with reverse Segond fracture. Our results do not support the association of knee dislocation and reverse Segond fracture.

Reverse Segond fracture is rare and it is not seen in conjunction with knee dislocation and PCL injury is not common when this fracture coexists with tibial plateau fracture.

Peltola, E, Lindahl, J, Koskinen, S, The Reverse Segond Fracture: An 11-Year Retrospective Study.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12027714.html